【作者】 韩燕；

【导师】 王孝哲；

【作者基本信息】 安徽大学 ， 伦理学， 2011， 硕士

【摘要】 医患关系是社会关系中的一种很重要的人际关系。医患关系的本质是医生与患者提供与接受医疗服务,他们之间有一个共同的目标就是要战胜疾病,减少痛苦,保障健康和生命安全。医患关系的状况跟人们的利益、人们的身心健康密切相关,更影响到社会主义和谐社会的建设。因此加强医患沟通、构建和谐的医患关系,有着极为重要的社会意义。在我国以前的计划经济时期,医院是政府办的公益事业单位,承担着医疗服务和政府救济双重职责。那时,城市中有着正规工作单位的人们享受公费医疗,没有工作单位的普通居民生病求医交的费用也很少；农村实行合作医疗,农民看病也不用花许多钱。在这样的体制下,医患之间没有太多的经济利益纠葛。那时的医患关系是比较单纯、干净的医疗关系。自改革开放和实行市场经济体制以来,医疗体制也进行了改革。医院也被要求市场化,减退了公益色彩,必须自谋利益。患者看病都要足额交费。于是,医患关系发生了很大的变化。医患之间既有医疗关系又有了经济利益关系。近几年医患关系发生巨大变化,有些医方和患方在处理彼此关系上都不够妥当,造成一些纠纷甚至激烈的冲突。医患关系比较紧张主要表现为：医患之间彼此缺乏信任,医疗纠纷增加；在医疗活动中发生过度检查现象使医疗费用过高,有的医院还乱收费；医务人员收受红包、回扣等行业不正之风一定程度的存在,败坏了医务人员的形象；个别患者或患者家属伤害医务人员,干扰正常的医疗秩序,甚至危及医务人员人身安全；看病难、看病贵导致患者不满情绪增加；社会对医务人员的总体评价负面形象增加,社会舆论压力加大等等。从伦理道德视角看,医患关系也是一种道德关系。医患关系中的非技术关系,主要是道德关系。信息不对称可能造成医患双方权利义务不明确,带来大量道德风险,加剧医患矛盾。这对于医疗行业健康成长以及构建和谐医患关系十分不利。我们要重视探讨医患关系中的道德风险的成因以及如何防范道德风险。我们必须明确在医患关系中双方分别有着怎样的权利和义务。从伦理道德角度说,在处理医患关系上,医务人员和患者都享有一定权利,也都承担一定的义务。彼此双方都应该以善的理念和态度善待对方。医务人员在医疗活动中,应该树立“以病人为中心”的理念和态度,尊重患者和善待患者,一切为患者着想,认真为患者服务。医务人员在处理与患者的关系上应该遵循的道德原则有自主原则、尊重原则、有利原则和不伤害原则。医务人员应该认真把患者知情同意权落到实处。医院应该建立伦理委员会,抓好医德医风建设,完善患者投诉机制。患者在求医时,也应该遵循社会公德和人际道德规范,善待医务人员。患者应该尊重医务人员,听从医务人员的诊疗举措,如果有意见要采取合法合理的方式来反映和求得解决。更多还原

【Abstract】 Physician-patient relationship is a social relationship is very important in relationships. Physician-patient relationship is the essence of doctors and patients receiving medical services and between them have a common goal is to fight disease, reduce suffering, protect the health and safety. The status of doctor-patient relationship with the people’s interests, people’s physical and mental health are closely related, will affect the construction of a harmonious socialist society. Therefore, strengthening the physician-patient communication and harmonious relations between doctors and patients, has a very important social significance.In our previous planned economy period, the hospital is government-run welfare institutions, medical services and bear the dual responsibilities of government assistance. At that time, the city has a formal work units for people to enjoy free medical care, no work unit to pay the ordinary residents of the cost of illness and rarely seek medical advice; rural cooperative medical practice, farmers do not have to spend a lot of money to see a doctor. In this system, the patient is not much between the economic interests of disputes. At that time the doctor-patient relationship is relatively simple, clean medical relationship.Since the reform and opening-up and implementation of a market economy has also been reformed health care system. Hospitals are also required to market, reduction of the public service image, must be self-interest. Patients should see a doctor in full payment. Thus, physician-patient relationship has undergone great changes. Relationship between doctors and patients have both medical economic interests. Doctor-patient relationship in recent years, tremendous changes, and some medical side and the contracting parties in dealing with mutual relations are not enough properly, resulting in a number of disputes and even violent conflict. Physician-patient relationship strained mainly as follows:lack of trust between doctors and patients, medical disputes increase; in the medical activity occurring in the phenomenon of excessive examination that medical costs are too high, and some hospitals also arbitrary charges; medical personnel receive a red envelope, kickbacks, etc. the presence of unhealthy degree, tarnished the image of medical personnel; individual patients or families of patients with medical personnel injury, interfere with normal medical order, and even endanger the safety of medical staff; medical treatment is difficult and expensive lead to increased patient dissatisfaction; community overall evaluation of the medical staff to increase the negative image, social pressures of public opinion and so on.From an ethical perspective, the physician-patient relationship is a moral relationship. Doctor-patient relationship in non-technical relations, primarily a moral relationship. Information asymmetry between doctors and patients rights and obligations may result not clear, bringing a lot of moral hazard, increasing patient contradiction. This is healthy growth for the medical industry as well as harmonious relations between doctors and patients is very unfavorable. We should pay attention to doctor-patient relationship of the causes of moral hazard and how to prevent moral hazard. We must be clear the two sides were in the doctor-patient relationship has what rights and obligations.From the ethical point of view, in dealing with the relationship between doctors and patients, medical staff and patients are entitled to certain rights, but also have certain obligations. Both should be good to each other’s ideas and attitudes to treat each other. Medical staff in the medical activity, should establish a "patient-centered" philosophy and attitude, respect for patients and treat patients, all for the sake of patients, serious for the patients. Medical staff and patients in dealing with the relationship between the moral principles should be followed the principle of autonomy, respect for the principle of benefit principle and the principle of no harm. Medical personnel should seriously implement the informed consent of patients. Hospital ethics committees should be established, do a good job medical ethics, improve patient complaint mechanisms. Patients seek treatment, they should follow public morality and interpersonal ethics, treating medical personnel. Patients should respect the medical staff, medical personnel listen to the diagnosis and treatment initiatives, to take legal advice if there is a reasonable way to reflect and seek to resolve.更多还原