医患共同体法治化建设的多方位思考

医患双方本是守望相助的共同体,但由于医疗活动“技术主体化”倾向严重,导致医疗行业引发诚信危机。立法较为侧重患者赋权,而挤压了医方合法权利的空间,法律在医患间利益关系的平衡上尚未发挥应有成效。法律规范应当合理配置医患间权利义务关系,完善知情同意规则和医疗保险相关法律体系,协调医疗资源的公平配置,为医患共同体建设营造良好法治氛围。国家应当充分发挥多元主体协同健康治理法治化的社会效用,重塑医疗诚信,拓宽医疗纠纷解决渠道,营造尊医重卫社会风气。

     

德性论视域下和谐"医患共同体"的构建

当前"医患共同体"的构建应当回归"德性基础主义"的建构路径.德性论思想从五个维度展现了其对构筑和谐"医惠共同体"的理论价值及意义.在和谐"医患共同体"的实际构建中德性价值具体表现在以下几方面:"环境和谐"的德性建构、"文化和谐"的德性塑造、"医疗和谐"的德性创设、"生命和谐"的德性构造.     

从平等与责任谈医患共同体何以可能

研究对“医患共同体”这一颇具可能性的命题进行分析,指出其成立的基础之一是对医患双方“分裂”处境的认知与承认,通过以对医患平等的探讨为起点,提出应将医、患双方知识/权力上的优劣转化为差异的能动性,在促进共同责任的基础上,建立在理论及实践的医患共同体。目前可能的临床实践包括鼓励医护讲述成为患者的真实体验,鼓励包括叙事医学在内的促进平等共情的实践以及赋能患者、使其具备更强能力参与医疗共同决策的实践等。

     

德性论视域下和谐“医患共同体”的构建

当前"医患共同体"的构建应当回归"德性基础主义"的建构路径。德性论思想从五个维度展现了其对构筑和谐"医患共同体"的理论价值及意义。在和谐"医患共同体"的实际构建中德性价值具体表现在以下几方面:"环境和谐"的德性建构、"文化和谐"的德性塑造、"医疗和谐"的德性创设、"生命和谐"的德性构造。     

“人类命运共同体”的伦理之维

"人类命运共同体"是基于全球化潮流、全球发展风险、国际新秩序构建等视角提出的新理念,也是走向世界过程中中国话语和中国声音的典型体现,不仅具有深刻的政治内涵,还具有深邃的伦理意蕴。它体现了资本逻辑全球化过程中对发展正义的追寻,凸显了多元文明场域中共同价值的守护,彰显了构建国际新秩序中中国的责任和道义担当。从伦理视角透视"人类命运共同体"这一理念,有助于展现其价值理性和实践诉求。     

论作为全球政治伦理的和平理念与规范——基于大国利益共同体与人类命运共同体之间差异的思考

作为全球政治伦理重要内涵的和平理念与规范,在形成初期是一种低阶的、消极的底线伦理,表现为西方大国基于现实实力差异而塑造的全球霸权与均势体系,是大国利益共同体的附属物,存在内在的不稳定性、权力与权利的非对称性及责任的不平衡性等问题。随着全球交往关系的显著变化,人类命运共同体理念与实践不断生成。在人类命运共同体视域下,人们形成了对以和平为核心的政治伦理理念与实践的自觉共识,将其视为自身应当主动承担的责任和义务,从而为全球政治伦理增添了高阶的、积极的底线伦理新内涵。这种新型的全球政治伦理在未来全球化进程中能够为全球和平与发展事业作出更为重要的贡献。     

和谐医患关系建设中的医患沟通艺术

在临床实践活动中,切身感悟到,建立和谐的医患关系,良好的职业道德素质是底线、娴熟的沟通技巧是保障、精湛的医疗技术是根本.必须重视诊疗过程中的沟通,知道患者想要得到什么,我们是否能够按照对方的心理需求去满足对方;沟通时对事不对人,如实告知患者医疗风险,平静应对患者告知后的知情不同意,这样,才能够最大限度增进了理解、促进医患和谐.     

社会转型时期"医患共同体"内部失和的政治学分析

"医患共同体"是一种生命共同体.当前,医患共同体内部失和导致频发医患纠纷,有其深刻的政治原因.宜从政治学角度重建和谐医患共同体:第一,平衡医患共同体内部利益;第二,保证医患双方利益协调制度的有效性;第三,重构医惠共同体普遍认同的价值基础.     

论人类命运共同体对西方共同体传统的革新

西方共同体理论虽然提出了许多有价值的思想,但是它从不积极主张世界性的共同体。在西方国家内部,公意沉默、价值多元等现象也让西方共同体理论失去其现实效力。人类命运共同体的理念革新了西方共同体理论的基础及其存在论前提,并以全人类“共同价值”改造西方共同体理论的一元价值体系。在避免西方共同体理论根本困境的同时,实现了对西方共同体传统的革新。     

关于构建和谐医患关系的思考

扼要介绍了医患关系令人担忧的现状及医患纠纷的总体特点,深入探讨了造成医患关系紧张的深层次原因,并据此从主观意识、医患的对立统一关系、医务工作者、患者、舆论和法律氛围等角度提出了构建和谐医患关系的意见和主张,并着重就如何深化改革、促进政府职能的转变与到位展开了阐述。     

Shared Values of Humanity Are the Ethical Foundation for Building a Human Community with a Shared Future

On the basis of recognizing the diversity of cultures and civilizations in the world and the existence of different values among people of different nations, regions, and countries, the shared values of humanity pursue after the largest common ground and greatest convergence of values of all mankind. Shared values of humanity are the deep cultural structure of a human community with a shared future, and value and ethical consensus is necessary to form at the global level to promote the building of a human community with a shared future. Shared values of humanity embody the public good of all peoples and countries in the world in the fields of common interests, needs, and development, serve as the ethical guidelines for reconstructing the rules for interaction and order of communication of the international society in the era of globalization, and represent the ethical vision for the development of a human community with a shared future. Shared values of humanity lay the ethical foundation for promoting the construction of a human community with a shared future. Specifically, peace and development represent the ethical consensus on the survival of the community; fairness and justice advocate the new ethical consensus on international relations formed within the framework of the community; and democracy and freedom demonstrate the political-ethical consensus of the community.     

Human Community with a Shared Future,Shared Values of Humanity and New Model for Human Advancement

The building of a shared community requires enduring efforts. The human community with a shared future is the largest community of human society for nation-states so far, an inevitable result of globalization. In this era, globalization needs to be oriented at demolishing the false universality in the past and rebuild the genuine universality, which makes building a human community with a shared future constructively logical in contemporary globalization. The new universality is the shared values of humanity. In essence, the shared values of humanity are a “common good” formed by all nations for their common interests, common needs, and common development, which makes them a new universality. The emergence and formation of the shared values of humanity was developed naturally in the long term among the exchanges of all nations. From the perspective of the thinking mode, the shared values of humanity focus on the “communicative rationality” in the intersubjectivity of the countries and the nations instead of hegemonic rationality, while adhering to the consultative principle. From the perspective of the internal structure, the shared values of humanity unite the value of existence and development. Their fundamental connotation reveals that the shared values of humanity dialectically unite cultural commonness and particularity. Building a human community with a shared future and its core shared values has in fact proposed a new model for human advancement. The fundamental connotations of the new model for human advancement can be classified into three aspects: new cultural value, the new paradigm of civilization, and new cultural experience.     

The Dialectic Relationship Between the Shared Values of Humanity and a Human Community with a Shared Future

General Secretary Xi Jinping deeply grasps the overall strategic situation of the great rejuvenation of the Chinese nation and great changes in the world unseen in a hundred years, and forms the important thought of carrying forward the shared values of humanity of peace, development, fairness, justice, democracy, and freedom and promoting the building of a human community with a shared future. The shared values of humanity provide value basis for the community, confirm the morality of the community, and lay the foundation of value recognition for building the community. A human community with a shared future is the practice area for the shared values of humanity, providing it with a real subject and delimiting the boundaries of the times. The shared values of humanity and a human community with a shared future complement each other, and are dialectically unified in the planning and grasp of the “two overall situations,” i.e., the overall strategic situation of the great rejuvenation of the Chinese nation and great changes in the world unseen in a century．     

急诊医学医患共同决策中的博弈分析

通过急诊医学的实践,借助博弈论方法分析了急诊医学中实施医患共同决策（shared decision making,SDM）的现状,为急诊医学中实施SDM提供参考意见。分析发现,在急诊医疗决策中存在“公地悲剧”“蜈蚣博弈”“博傻理论”等博弈现象。急诊医学中的信息技术滞后、医患对SDM的认知不足、医患信任等因素是影响SDM在急诊医学中实施的重要博弈因素。通过推动急诊医学的信息化建设、SDM理念的普及和技能培训,借助博弈论的方法和相关法律制度的完善,提升互联网作为健康宣传和健康教育的工具作用,有利于SDM在急诊医学的应用推广,从而促进急诊医学和谐医患关系的构建。

     

论构建和谐医患关系的社会责任

围绕近年来备受社会关注的医患关系,对当前医患关系不和谐的社会失责进行了分析,认为造成这种失责原因是医疗体制不合理、社会卫生保障制度不完善、医疗卫生改革滞后、医药市场存在严重弊端、医学人文教育不尽人意等。在此基础上,明确提出构建和谐医患关系的社会责任是要建立平等互惠的医患关系、完善和谐医患关系的制度建设、建立有效的社会监督体系、健全社会医疗保障体系、深化医疗卫生体制改革、加强对医患冲突的社会管理等。     

The Shared Values of Humanity and Its Philosophical Implications: From the Perspective of Civilization

The concept of the shared values of humanity, embodying the spirit of putting people first and solving real-life problems, is of great significance for constructing a new global order and building a human community with a shared future. The shared values of humanity respect the differences in understanding and realization paths of different civilizations, and seek common grounds with an inclusive and open attitude. The core socialist values are an embodiment and an extension of the shared values of humanity. The fine traditional Chinese culture has also laid a profound cultural basis for the pursuit of the shared values of humanity, enabling us to make up a better scheme for building a human community with a shared future from the perspective of civilization.     

生成式人工智能对于医患关系的伦理重构

基于对生成式人工智能医学能力、风险以及第三者效应的综合考量,分析生成式人工智能介入医患关系可能构成的四种伦理转向：即“医−人工智能−患”共同决策模式（可能Ⅰ）、“患−人工智能”深度协作与医生保守立场（可能Ⅱ）、恢复传统“医−患”关系（可能Ⅲ）以及“医−人工智能”深度协作与患者保守立场（可能Ⅳ）。其中“医−人工智能−患”共同决策模式的交互本质可能进一步形成两种相互背离的发展取向：一是以患者为中心的医疗实践模式,二是计算机主义的医疗家长主义。

     

医患关系何解？——医者患病经历文献述评

综述医者患病经历相关文献发现,医、患分野和矛盾植根于医学和医学模式本身,是在现代医学发展过程中被建构出来的,解决医患关系问题应着眼于审视和改变医学文化和医学模式内部造成医患矛盾、分歧的根本原因,创造机会打破严格的医、患角色区隔,实现病人得治、医者得安、医患共同。在医者患病经历文献中,能追溯医患同源的起点,能洞悉医患分化和冲突所在,也能看到形成医患共同体的可能性,为实现和谐医患关系指明方向。

     

人类命运共同体信念的结构探索与量表编制

党的十八大提出“倡导人类命运共同体意识”。人类命运共同体信念的心理结构尚不清晰,亦缺乏有效的测量工具。研究一和研究二分别采用词汇自由联想和质性研究对人类命运共同体信念进行结构探索。研究三编制了人类命运共同体信念量表,并检验其信效度。结果显示,人类命运共同体信念包含四个因子,分别为和平共处、休戚与共、合作互助和可持续发展。人类命运共同体信念量表具有良好的信、效度,符合心理测量学标准,可用于人类命运共同体信念的测量。