医患关系问题及其解决的伦理学研究

发布时间：2017-12-27 15:06

本文关键词：医患关系问题及其解决的伦理学研究　出处：《中国矿业大学》2016年硕士论文　论文类型：学位论文

【摘要】：医患关系是医疗方与病患方在疾病诊疗过程中产生的特定医治关系,是社会关系在医疗卫生领域的缩影,也是医疗领域人际关系中的关键。随着科技和社会的发展,医患关系已经由传统的医生和病人的关系逐步演化为医方和患方的关系问题。由于我国经济社会体制改革,社会文化发展,公共利益、商业利益以及个人利益不断变革、重组和整合,相关利益分配格局被重新界定,医患关系问题也从内容到形式都发生了深刻的变化。其不是单一的个案、也不是简单的纷争,而是医患关系背后利益博弈、制度设计以及伦理失范等深层问题的外在表象。医患关系问题的缓解或消除需要从认清医患关系的实质和内涵入手,要看到医患关系本质上是一种供需关系。但这种供需关系不仅包括商品交换关系成分,还包括道德关系成分。因此,治理医患关系问题不仅需要考虑商业利益博弈,还需要从伦理学视角加以认识,深入到伦理学的道德关系、心理契约关系以及伙伴关系等层面上去并厘清双方因素之间的内在影响关系,而这也是此选题的主要研究域。结合对国内外医患关系问题研究动态和文献情况的把握,基于伦理学层面的分析,发现当前医患关系问题表现为复杂的伦理关照。这种伦理关照以三种典型的危机存在:以患者不信任为诱因的信任危机,以对医疗行业期待过高为诱因的期望危机,以医方冷漠为诱因的人文关怀危机。同时,研究还发现以这些危机为代表的伦理关照是多因素驱动的结果。包括医疗制度正义不足,医患双方信息不对称造成的彼此信任危机,功利主义僭越道义伦理造成的期望危机。在对医患关系问题的本质及内涵、产生的主要因素进行系统研究的基础上,针对性地提出了对当前我国医患关系问题的治理策略。具体包括:建立健全具有正义性的医疗保障体系识、建立健全旨在和谐医患关系的医疗伦理委员会、建立基于道德信仰的文明医患关系等。
[Abstract]:Doctor-patient relationship is the specific healing relationship between the medical side and the patient in the process of disease diagnosis and treatment. It is a microcosm of social relations in the medical and health field, and also the key to the interpersonal relationship in the medical field. With the development of technology and society, the doctor-patient relationship has by the traditional relationship between doctors and patients gradually evolved into the relationship between doctors and patients. Because China's economic and social system reform, social and cultural development, public interest, business interests and personal interests are constantly changing, restructuring and integration, the distribution pattern of related interests has been redefined, and the relationship between doctors and patients has also undergone profound changes from content to form. It is not a single case, nor a simple dispute, but an external representation of deep issues such as interest game, institutional design and ethical anomie. The relief or elimination of the problem of doctor-patient relationship should start with the understanding of the essence and connotation of the doctor-patient relationship, and the relationship between doctors and patients is essentially a supply and demand relationship. But the relationship between supply and demand includes not only the components of commodity exchange, but also the elements of moral relations. Therefore, the doctor-patient relationship governance not only need to consider the business interests of the game, also need to be understood from the perspective of ethics, further to ethics moral relations, psychological contract relationship and partnership level and to clarify the intrinsic influence relationship between factors, and it is also the main research fields of this subject. Based on the analysis of the dynamics and literature of the doctor-patient relationship at home and abroad, based on the ethical analysis, it is found that the current doctor-patient relationship is a complex ethical concern. This ethical care exists in three patients with typical crisis: don't trust for trust crisis inducement, the medical industry expect too much incentive to expect the crisis, both indifference incentive humanistic crisis. At the same time, the study also found that the ethical care represented by these crises is the result of multiple factors. Including the medical system justice problem, caused by the information asymmetry between doctors and patients trust crisis, caused by the utilitarian moral ethics crisis expectation transgression. On the basis of systematic research on the nature and connotation of the doctor-patient relationship and the main factors, this paper puts forward the governance strategy for the current doctor-patient relationship in China. Specifically, we should establish a sound medical insurance system, establish a sound medical ethics committee aimed at harmonious doctor-patient relationship, and build a civilized doctor-patient relationship based on moral belief.
【学位授予单位】：中国矿业大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：B82-059

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