医疗决策模式中权力权利与文化的变迁及启示

doi:10.16460/j.issn1008-9969.2021.16.074

护理学报 ›› 2021, Vol. 28 ›› Issue (16): 74-78.doi: 10.16460/j.issn1008-9969.2021.16.074

• 伦理与法 • 上一篇

医疗决策模式中权力权利与文化的变迁及启示

蒙艺¹, 陈玲¹, 邹丽琴²

1.重庆工商大学法学与社会学学院,重庆 400067;
2.陆军军医大学第一附属医院,重庆 400030

收稿日期:2021-03-23 出版日期:2021-08-25 发布日期:2021-09-10
通讯作者: 邹丽琴（1980-）,女,重庆人,博士,教授。E-mail：lqzou2006@163.com
作者简介:蒙艺（1973-）,女,贵州纳雍人,博士,副教授,硕士研究生导师。
基金资助:
2019年重庆市教委人文社会科学规划项目（19SKGH093）; 2019年重庆市研究生教育教学改革研究项目（yjg193107）; 重庆工商大学创新型科研项目（yjscxx2020-094-13）

Power, Rights and Culture: An Implication from Changes of Medical Decision-making Mode

MENG Yi¹, CHEN Ling¹, ZOU Li-qin²

1. School of Law and Sociology, Chongqing Technology and Business University, Chongqing 400067, China;
2. The First Affiliated Hospital, Army Medical University, Chongqing 400030, China

Received:2021-03-23 Online:2021-08-25 Published:2021-09-10

摘要/Abstract

摘要： 目的理清医疗决策模式的历史变迁及演变逻辑,探讨符合当时当下的理想医疗决策模式。方法围绕医疗决策的概念内涵及模式变迁,梳理、分析和评价国内外相关文献。结果医疗决策的内涵界定存在过程、结果和行为3大流派,但均存在决策主体不明的问题。医疗决策模式在现代医学发展史上,随着对医方权力和患方权利的认知变化经历了3个重大转变,分别是家长式决策模式,知情决策模式和共享决策模式。但是,现代医学传到中国,上述3种模式妥协于本土文化,演变为儒家家庭主义模式。结论理想的医疗决策模式,应该是在临床治疗和护理方案决策过程中,信任医方权威、保障患者权利、尊重患者偏好和尊敬本土文化。

关键词: 医疗决策模式, 权力, 权利, 文化

Abstract: Objective To clarify the historical changes and evolution logic of medical decision-making mode, and to explore an ideal medical decision-making mode. Methods We analyzed and evaluated relevant literature at home and abroad on concept connotation and changes of medical decision-making mode. Results There were three schools in the connotation of medical decision-making in terms of process, result and behavior, but all of them had the problem of unclear decision-making subject. In the history of modern medical development, the medical decision-making mode had undergone three major changes with the cognitive changes of doctors’ rights and patients’ rights, which were paternalistic decision-making model, informed decision-making mode and shared decision-making mode. However, after the spread of modern medicine to China, and the above-mentioned three modes had evolved into Confucian familism because of local culture. Conclusion The ideal medical decision-making mode consists of trusting the authority of doctors, protecting patients' rights, respecting patients’ preferences and local culture in the decision-making process of clinical treatment and nursing programs.

Key words: medical decision-making model, power, rights, culture

中图分类号:

蒙艺, 陈玲, 邹丽琴. 医疗决策模式中权力权利与文化的变迁及启示[J]. 护理学报, 2021, 28(16): 74-78.

MENG Yi, CHEN Ling, ZOU Li-qin. Power, Rights and Culture: An Implication from Changes of Medical Decision-making Mode[J]. Journal of Nursing, 2021, 28(16): 74-78.

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医疗决策模式中权力权利与文化的变迁及启示

Power, Rights and Culture: An Implication from Changes of Medical Decision-making Mode

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