Trust And Reconstruction Of Patient-Physician Relationship In China

Patient-physician relation, as the fundamental issue in medical relationships, is an ethical, to be exact, a bioethical existence. Any school of bioethics, so far as the issue of patient-physician relationship is not tackled, would not be an integrated bioethics. All bioethics, constructed in various systems, regard the theoretical settlement of patient-physician relationship as the utmost task. Similarly, the society regards the building of patient-physician relationship as a significant task in self-improvement and development. This dissertation, from the bioethical point of view, researches on the core of patient-physician relationship, that is, patient-physician relationship as a moral relationship. It points out that the construction of a trust-based patient-physician relationship is the efficient approach to the settlement of patient-physician conflicts. As regards the construction of trust relationship, it puts forth the resolution scheme of integrated moral views on life and one conforming to the three ethical principles. Following this train of thought, this dissertation is divided into following chapters:Chapter One: Through reflecting on the history of patient-physician relationship, it concludes that this relationship underwent a process from silence, through an intension to the now conflicting state. It argues that the prolonged history of silence is to blame for the emergence of conflicting status quo. The cause for such silence has been the monologue relationship formed in the long history of paternalistic practice; while the cause for conflict has been the loss of trust between two parties.Chapter Two: It critically analyzes the practical and theoretical efforts people have made to ease patient-physician relations. It points out the limitation of the new medical model itself and the cause for its inadequate implementation in China. It re-dissects the dissection of the four most widely-concerned patient-physician relation models and points out its theoretical drawbacks, and thus arguing that the solution on technological level cannot really settle theconflicts between two parties.Chapter Three: In this chapter, three different kinds of medical activities will be analyzed, and according to different medical activities, patient-physician relations will be categorized on three levels. By analyzing the existing defining research on patient-physician relationship, it argues that the technological relationship is the basis of patient-physician relationship and moral relationship the core. These two are technologically a complicated advice-service and direction-cooperation relationship and morally a trust-oriented moral relationship. It argues that the overrun of patient rights is the result of the loss of trust and emphasizes that the carrying out of physician responsibility is the due choice to harmonize the two. And it, by comparing the conceptions of trust in Chinese and Western ethics, especially bioethics, discusses why a trust-oriented patient-physician relationship is feasible. On the basis of this, this chapter mainly deals with the problem of how to construct the trust-oriented patient-physician relationship, and it argues that any bioethics that lacks an integrated, stable and consistent moral view on life will inevitably canonize casuistry and approaches of situational ethics and therefore do harm to the extent of trust between patients and doctors. And it holds that the establishment of a kind of integrated moral views on life in consistent with the goal of current medicine is the premise to the cultivation of trust relationship and the adherence to the bottommost ethical principles aiming at the three different levels of patient-physician relations is the foundation of trust relationship between two parties.Chapter Four: this chapter analyzes the reasons for the inclusion of the principle of respecting autonomy into bioethics, and mainly discusses the problems in theory and practice brought forth by the manifestation of this principle, namely,...