轉型社會中醫患關係的觀念格局

Physician-Patient Relation in Transitional China

Abstract

LANGUAGE NOTE | Document text in Chinese; abstract also in English.

轉型社會條件下醫患之間常常充滿了道德困境和失序，但是對於醫患關係的意識狀態缺乏必要的刻畫和描述。本文試圖通過一個常見事例的解析，說明醫患關係在中國傳統文化背景下的特質，尤其是儒家文化的影響。另一方面，西學東漸以來，西方科學精神以及西方倫理制度對中國醫界觀念的作用和影響也有獨特的反映。那麼，其中的優劣互見最終要落實到循著本土的文化邏輯和價值觀衍生具有生機和活力的醫患關係的觀念格局。

In describing the situation of physician-patient relationship in current China, some like to characterize it by adopting popular Western concepts, principles and theories. As a result, the concept of "patient rights" has been a cliché in such discussion. While this concept may be important to appeal to in laying out some relevant issues as well as working out proper solutions, it by no means constitutes an exhaustive intellectual and moral network of resources to deal with the Chinese situation regarding the physician-patient relation. Instead, the physician-patient relation in China has been shaped by the moral thought and practice of Confucian tradition in a long history, which continuously informs the interplays between Chinese physicians and patients in current transitional China. Instead of being led by any ideas of patient rights and individual contracts, Chinese physicians, families as well as patients themselves are closely engaged in a value system in which the Confucian virtues and relation models direct medical practice in general and the physician-patient relation in particular. Confucian values and cultural factors , such as "following your moral conscience", "looking for connections in solving difficulties" and "giving a face to a friend" , have been salient in reality. It is difficult to resolve any problems resulting from this practice by appealing to rights and contracts intertwined in Western individualistic culture. Chinese bioethicists, in order to provide feasible and ethical guidance to current Chinese practice, must carefully study the Confucian values and their operating mechanisms in biomedical reality. If they simply expect to sit and relax by introducing modern Western concepts and ideas such as "patient rights" and "contracts" , they will end up without offering any real assistance.

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