中国当前的医疗危机与医护人员的专业责任和使命

分析了导致当前国内医患关系恶化的种种宏观与微观的因素,认为其中最重要的原因是医患关系中出现不应存在的利益冲突,最终导致医患关系出现一种诚信危机。以此为讨论起点,分析了西方国家的信托模式的七种特征,论证医患关系的本质为何是一种信托关系,并指出忠诚与守信是信托关系和医疗专业精神的核心价值。在结论中特别指出,这种认知明确了医疗专业在当前的医患危机中应该扮演的角色和担当的责任。     

医患诚信问题解析

医患诚信是现代中国医患关系中的一个重要问题.但当前学界在对医患关系问题进行讨论时,缺少对该问题的深入而细致的分析.指出当前对中国医患诚信问题的研究存在着四个方面的问题.其中,医患诚信危机是理解医患关系现状的关键点,剖析中国医患关系问题的着力点,重构医患诚信更是扭转医患关系紧张的切入点.     

医患诚信问题解析

医患诚信是现代中国医患关系中的一个重要问题。但当前学界在对医患关系问题进行讨论时,缺少对该问题的深入而细致的分析。指出当前对中国医患诚信问题的研究存在着四个方面的问题。其中,医患诚信危机是理解医患关系现状的关键点,剖析中国医患关系问题的着力点,重构医患诚信更是扭转医患关系紧张的切入点。     

"柔性支架"——社会工作方法介入医患危机

和谐的医患关系是医疗服务的核心,但是在我国现阶段的医患关系表现得相当复杂,已经成为一个比较严重的社会问题,需要我们进行理论上的反思和实践上的探索.运用个案工作、小组工作和社区工作等社会工作方法与技巧介入医患危机,将成为解决医患关系的"柔性支架",对缓解医患危机将起到非常重要的作用.     

社会工作视野下构建和谐医患关系的策略分析

和谐的医患关系是一切医疗活动的基础。面对当前医患关系中的不和谐现象,不同学者对其形成的原因及其对策进行了多学科的探索。作为一种以利他主义为指导的专业助人服务活动,社会工作则提供了一种介入医疗纠纷问题的崭新视角。在协调医患关系的过程中,医务社会工作需要面向病患及其家属、医护人员、医院管理层、社会及大众媒体、政府公共卫生管理部门等不同的主体,发展出不同的工作策略,扮演不同的服务角色。     

卓越医学之医药专业质素:中国传统医患关系之现代功能

从中国传统之医疗专业和医患关系发掘出中国医药所具有的一种视医疗为仁术、视病犹亲的医患关系,合理回应中国传统社会特别重视的医师与病人和病人家属所结合成的亲密关系,重修医患与家属互相信任的方向,即建立一种家人之间的内在的信任关系,让病患与家属感受到医护人员的真诚和专业的服务.最后建议医院方面提高专业质素的具体表现,使病人有回家的感受,提升医疗的质量.     

医患沟通模式的比较研究

医患关系是医疗人际关系中最重要最具特点的关系,和谐医患关系是一切医疗活动的基础,也是建构和谐社会的基本条件.而医患沟通是良好医患关系的最基本、最主要的因素之一.本文就长期以来形成的医患沟通的五种理论模式进行简单论述和评论,主要强调各个模式医患沟通目标的不同、各个模式中医生的职责和患者价值在其中的作用以及各个模式的优缺点及临床应用与实践.其目的在于通过评价和对比来为我国和谐的医患关系推荐一个比较好的医患沟通模式.     

签署知情同意书有助于改善医患关系

当前医疗活动中由于缺乏人文关怀、患者对医务人员信任度下降以及医患之间信息不对称,导致现阶段医疗投诉以及医疗纠纷逐年上升,投诉和纠纷内容多样且性质趋于严重复杂.在签署医疗知情同意书时,适时给予病人情感上的关爱,重视病人心理需求,采取医学技术与人文关怀相结合的医疗活动,有助于在现代医学模式基础上构建和谐的医患关系.     

住院医师医患沟通的问题及对策

医患沟通是新时代住院医师必须掌握的一门技能,是医学人文精神的体现。然而目前我国住院医师由于专业知识及技术的局限性,对医患沟通的认识存在着偏倚,以及我国医学教育缺乏沟通能力的培养,导致住院医师医患沟通能力缺乏,需要提高改善。本文基于当前医患关系以及住院医师医患沟通能力的现状,探讨为提高医疗服务质量,增进医患之间的相互理解和尊敬,创建和谐医疗关系,积极有效防范医疗纠纷,身为住院医师的我们应做些什么,做到什么。     

论信息不对称境遇下患者的诚信期待异化

当前我国医患危机境遇是一种价值选择困境,根源在于医患之间的信息不对称.历史经验与现实体验强化患者对医方的信任,患者在共同的诚信建构过程中变得懒惰,其行为本质上是患者医疗健康权利的非理性扩张,最终导致信息不对称境遇下患者诚信期待异化.反思患者自身的思维方式是消除诚信期待异化、重建医患诚信的必由之路.     

价值观和卫生保健:卫生改革中的儒学思考

历史和文化传统影响普遍的社会价值观和卫生保健资源分配.东亚各国儒家思想根深蒂固,新加坡也不例外.新加坡采用注重实效,结合儒家思想,中西交汇,发展出一种独特的成本共享模式.新加坡例子表明改革需要结合本国国情,儒家维度思考是对东亚各国卫生保健改革很有帮助的切入点.     

Gender Mainstreaming and Healthcare Policy

This review addresses how The Palgrave Handbook of Gender and Healthcare structures and analyzes the themes that emerge from its own interrogation of the complex concepts of gender, equality, health and policy. Overall the review takes a complimentary tone towards the handbook's arguments and premises and the unique research that sets it apart from other more scientifically or development based gender health texts. It points out, however, that the book maintains its focus on the global north and the efficacy of state policy as the primary tool for gender equality, however defined. The author suggests that in future discussions, the alternative routes and different countries that are only just touched on in the text should be more thoroughly explored.     

Narrative Medicine and Healthcare Reform

Narrative medicine is one of medicine's most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is not easy to describe. Many of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context.     

家庭完整性与可持续性医疗改革:医疗储蓄账户的重要性

家庭的存在不仅仅是创造个体和/或国家；家庭是一个独特的现实存在物,作为一种社会存在的范畴,使得个体的生物存在和道德存在的完整性得以实现.家庭是一个存在,使得善的特殊结构得以实现,使得人类繁荣的核心区域的必要条件得以维持.家庭不仅利于揭示事实的真相也展示了一种规范性承诺.论述了意识到家庭存在及其基本作用的重要性,探讨了基于家庭的医疗储蓄对维持家庭完整性的意义,同时也指出提供长期可持续医疗卫生改革的重要作用.     

Healthcare,Responsibility and Golden Opportunities

When it comes to determining how healthcare resources should be allocated, there are many factors that could—and perhaps should—be taken into account. One such factor is a patient’s responsibility for his or her illness, or for the behavior that caused it. Policies that take responsibility for the unhealthy lifestyle or its outcomes into account—responsibility-sensitive policies—have faced a series of criticisms. One holds that agents often fail to meet either the control or epistemic conditions on responsibility with regard to their unhealthy lifestyles or their outcomes. Another holds that even if patients sometimes are responsible for these items, we cannot know whether a particular patient is responsible for them. In this article, we propose a type of responsibility-sensitive policy that may be able to surmount these difficulties. Under this type of policy, patients are empowered to change to a healthier lifestyle by being given what we call a ‘Golden Opportunity’ to change. Such a policy would not only avoid concerns about patients’ fulfilment of conditions on responsibility for their lifestyles, it would also allow healthcare authorities to be justified in believing that a patient who does not change her lifestyle is responsible for the unhealthy lifestyle. We conclude with a discussion of avenues for further work, and place this policy in the broader context of the debate on responsibility for health.

     

Religious Reasons and Public Healthcare Deliberations

This paper critically explores the path of some of the controversiesover public reason and religion through four distinct steps.The first part of this article considers the engagement of JohnFinnis and Robert P. George with John Rawls over the natureof public reason. The second part moves to the question of religionby looking at the engagement of Nicholas Wolterstorff with Rawls,Robert Audi, and others. Here the question turns specificallyto religious reasons, and their permissible use by citizensin public debate and discourse. The third part engages JürgenHabermas's argument that while citizens must be free to makereligious arguments, still, there is an obligation of translation,and a motivational constraint on lawmakers. The final sectionargues that even though Habermas's proposal fails, neverthelesshe recognizes a key difficulty for religious citizens in contemporaryliberal polities. Restoration of a full role for religiouslygrounded justificatory reasons in public debate is one partof an adequate solution to this problem, but a second plankmust be added to the solution: recognition that religious reasonscan enter into public deliberation not just as first-order justificationsof particular policies, but as second-order reasons, to be consideredby any polity that respects its religious citizens and, morebroadly, the good of religion.     

Justice,Health, and Healthcare

Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness."