scholarly journals 中國“病人自主權”的歷史演變——20 世紀80 年代之前

2018 ◽  
Vol 16 (1) ◽  
pp. 97-113
Author(s):  
Guobin CHENG
Keyword(s):  
Political Ideology ◽  
Patient Autonomy ◽  
Chinese Culture ◽  
The Political ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Historical Outline ◽  
Digital Commons ◽  
Medical Concepts ◽  
Physician Patient

LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文簡要梳理了從帝制時代到上世紀80 年代之前中國病人自主狀況和相關社會理念的演變過程，並對其出現的特定歷史條件進行了初步分析。中國傳統的病人自主權是整合在社會禮法秩序中的病人家長制。雖然從中國近代到新中國成立初期，病人自主狀況和自主權的概念都發生了一定的變化，但因為它們幾乎都屈從於這兩個階段的社會政治運動，所以無法實現基礎倫理結構和價值觀的轉變。目前中國從西方引入的現代個人主義式的病人自主權概念，不僅與傳統的理解存在巨大差異，也與當前的醫學生活與社會制度不完全匹配。在中國解決病人權利保護的難題，不是任何一種單一化的理念引進、制度改造或者政治運動就可以實現的，我們必須把自己的思考投入到那個歷史與當下、理論與現實、中國與西方糾纏在一起的真實的世界，才有可能發現問題的癥結並找到正確的方向。This essay offers a historical outline of the evolution of patient autonomy and related social and medical concepts in China from the imperial era to the 1980s. The author contends that the idea of patient autonomy was totally absent from traditional Chinese culture, as every area of society, from family to medicine, was structured according to a distinctively paternalistic model and regulated by ritual guidelines (lifa). Although the Western medical practices that arrived in China in the 1840s somewhat altered the Chinese approach to medicine, and the physician-patient relationship was viewed in a more egalitarian manner after the establishment of “new China” in 1949, the effects of these changes were minimal due to the political ideology of the time. The author argues that taking a historical perspective on the issues of patient autonomy and the rights of patients in China will aid understanding of the current challenges facing medicine in China and suggest ways of resolving ethical dilemmas and ambiguities at both a theoretical and a practical level.DOWNLOAD HISTORY | This article has been downloaded 122 times in Digital Commons before migrating into this platform.

scholarly journals “扁鵲見蔡桓公”——對一則古代案例的倫理學回顧

2012 ◽  
Vol 10 (2) ◽  
pp. 73-91
Author(s):  
Jianguang WANG
Keyword(s):  
Informed Consent ◽  
Patient Relationship ◽  
Ancient China ◽  
Physician Patient Relationship ◽  
Ethical Implications ◽  
Digital Commons ◽  
Serious Disease ◽  
Physician Patient ◽  
Chinese Physician

LANGUAGE NOTE | Document text in Chinese; abstract also in English.扁鵲是中國先秦時期著名的醫生，同時也是中國傳統醫學和醫學倫理的奠基者和實踐者之一。他在與蔡桓公的幾次會面中作出的對話，有著豐富的道德內涵，展示了傳統醫患之間的一種具有特色的醫學倫理。中國傳統的醫學倫理和職業精神並不把醫生僅僅看成是一個純粹的技術性職業，而是賦與其中豐富的人生道德內涵和家國天下的思想，所以在西方醫患關係中被認為是十分重要的知情同意問題，在中國傳統的醫患關係中雖然也存在，但並沒有成為中國傳統醫患關係的主體。與之相反，中國傳統的醫患關係因為是建立在“上醫醫國”的文化土壤中的，醫患之間的關係也是在綱常倫理的維度中加以調適的，所以這種關係不僅僅是今天意義上的權利和義務、知情和同意等法律屬性的關係。Bian Que is the earliest known Chinese physician of the Pre-Qin era (ca. 700 B.C.E), whose name is often associated with physicians of the highest medical caliber. One legend tells of how when Bian Que was in the feudal state of Cai, he visited the Lord Huan and told him that he had a serious disease. The Lord Huan thought Bian Que was trying to profit from the fears of his patients and declined the offer for treatment. Eventually, Lord Huan’s condition got worse. The last time Bian Que went to see Lord Huan, he knew that the lord would soon die and escaped from the state. This essay considers the ethical implications of the legend, such as the moral duty of the physician and the nature of the physician-patient relationship. Did Bian Que violate informed consent when he failed to tell the lord he would die of the disease if not treated immediately? The author concludes that the role of physician in ancient China was quite different from what one sees today. Thus, modern ideas and concepts such as informed consent and the language of rights cannot be applied to the case of Bian Que.DOWNLOAD HISTORY | This article has been downloaded 182 times in Digital Commons before migrating into this platform.

Simulation-Based Training of Communication and Emotional Competence for the Improvement of Physician-Patient Relationship

2006 ◽  
Author(s):  
Luigi Anolli ◽  
Fabrizia Mantovani ◽  
Alessia Agliati ◽  
Olivia Realdon ◽  
Valentino Zurloni ◽  
...  
Keyword(s):  
Emotional Competence ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Simulation Based ◽  
Physician Patient

Models of the Physician-Patient Relationship

JAMA ◽  
1992 ◽  
Vol 268 (11) ◽  
pp. 1411
Author(s):  
Judith Andre
Keyword(s):  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Physician Patient

Prudence in Shared Decision-Making: The Missing Link between the “Technically Correct” and the “Morally Good” in Medical Decision-Making

2020 ◽  
Author(s):  
Paul Muleli Kioko ◽  
Pablo Requena Meana
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Patient Autonomy ◽  
Intellectual Ability ◽  
Medical Decision ◽  
Shared Decision ◽  
Physician Patient Relationship ◽  
Good Healing ◽  
The Right ◽  
Physician Patient

Abstract Shared Decision-Making is a widely accepted model of the physician–patient relationship providing an ethical environment in which physician beneficence and patient autonomy are respected. It acknowledges the moral responsibility of physician and patient by promoting a deliberative collaboration in which their individual expertise—complementary in nature, equal in importance—is emphasized, and personal values and preferences respected. Its goal coincides with Pellegrino and Thomasma’s proximate end of medicine, that is, a technically correct and morally good healing decision for and with a particular patient. We argue that by perfecting the intellectual ability to apprehend the complexity of clinical situations, and through a perfection of the application of the first principles of practical reason, prudence is able to point toward the right and good shared medical decision. A prudent shared medical decision is therefore always in keeping with the kind of person the physician and the patient have chosen to be.

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