本文關鍵詞：醫(yī)患關系問題及其解決的倫理學研究　出處：《中國礦業(yè)大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 醫(yī)患關系 醫(yī)患關系問題 倫理關照 倫理策略

【摘要】：醫(yī)患關系是醫(yī)療方與病患方在疾病診療過程中產生的特定醫(yī)治關系,是社會關系在醫(yī)療衛(wèi)生領域的縮影,也是醫(yī)療領域人際關系中的關鍵。隨著科技和社會的發(fā)展,醫(yī)患關系已經由傳統(tǒng)的醫(yī)生和病人的關系逐步演化為醫(yī)方和患方的關系問題。由于我國經濟社會體制改革,社會文化發(fā)展,公共利益、商業(yè)利益以及個人利益不斷變革、重組和整合,相關利益分配格局被重新界定,醫(yī)患關系問題也從內容到形式都發(fā)生了深刻的變化。其不是單一的個案、也不是簡單的紛爭,而是醫(yī)患關系背后利益博弈、制度設計以及倫理失范等深層問題的外在表象。醫(yī)患關系問題的緩解或消除需要從認清醫(yī)患關系的實質和內涵入手,要看到醫(yī)患關系本質上是一種供需關系。但這種供需關系不僅包括商品交換關系成分,還包括道德關系成分。因此,治理醫(yī)患關系問題不僅需要考慮商業(yè)利益博弈,還需要從倫理學視角加以認識,深入到倫理學的道德關系、心理契約關系以及伙伴關系等層面上去并厘清雙方因素之間的內在影響關系,而這也是此選題的主要研究域。結合對國內外醫(yī)患關系問題研究動態(tài)和文獻情況的把握,基于倫理學層面的分析,發(fā)現(xiàn)當前醫(yī)患關系問題表現(xiàn)為復雜的倫理關照。這種倫理關照以三種典型的危機存在:以患者不信任為誘因的信任危機,以對醫(yī)療行業(yè)期待過高為誘因的期望危機,以醫(yī)方冷漠為誘因的人文關懷危機。同時,研究還發(fā)現(xiàn)以這些危機為代表的倫理關照是多因素驅動的結果。包括醫(yī)療制度正義不足,醫(yī)患雙方信息不對稱造成的彼此信任危機,功利主義僭越道義倫理造成的期望危機。在對醫(yī)患關系問題的本質及內涵、產生的主要因素進行系統(tǒng)研究的基礎上,針對性地提出了對當前我國醫(yī)患關系問題的治理策略。具體包括:建立健全具有正義性的醫(yī)療保障體系識、建立健全旨在和諧醫(yī)患關系的醫(yī)療倫理委員會、建立基于道德信仰的文明醫(yī)患關系等。
[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.
【學位授予單位】：中國礦業(yè)大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：B82-059

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