Ethical Reflection On The Construction Of China’s Hierarchical Medical System

Along with deepening of the medical reform,Chinese medical and health service have made great strides.Nevertheless,the current medical resources and development level in China cannot yet satiate Chinese demand for high quality medical and health services.In China,when a patient becomes ill,he or she tends to see a doctor in a third-grade hospital.As a result,many large-scale third-grade hospitals are overcrowded with patients;the medical workers are worn out in serving the patients;and the patients have great difficulty in seeing a doctor.Moreover,the patient-doctor relationship becomes growingly tense.On the contrary,the grassroots medical institutions are gradually declining for their service quality fails to win public trust.For the health of the people and the fundamental improvement of people’s livelihoods,promotion of the graded diagnosis and treatment system is a must.As an important part of medical reform,the graded diagnosis and treatment is endowed with the humanistic feelings and ethical significance.On the path of constant exploration,relevant experience has been accumulated,but there are still some problems to cope with.The graded diagnosis and treatment system should extensively,comprehensively,deeply and effectively abide by the ethical principles for the purpose of more reasonable allocation of medical resources and equal access to quality medical and health services.In this paper,existing research findings related to graded diagnosis and treatment system and the medical reform ethics at home and abroad are first reviewed.The private clinics,community health service centers,and medical institutions of the first grade,second grade and third grade are visited.The qualitative interview is combined with the interdisciplinary ethical and management analysis for a thorough investigation of the research issue in this paper.By referring to the graded diagnosis and treatment system and ethics at home and abroad,Section 1 and Section 2 expound on the ethical significance of China’s graded diagnosis and treatment system construction,which mainly includes humanitarianism,fairness and public welfare.To be specific,the graded diagnosis and treatment system has ensured Chinese demands for basic medical and health services to be satiated;promoted fair distribution of medical resources and services by implementing the socialist humanistic spirit;and guaranteed medical and health services to be a public welfare.Section 3 mainly examines the ethical principles to which the graded diagnosis and treatment system construction must adhere to.These principles can be divided into basic principles for medical ethics(including principle of public good,principle of respect,principle of fairness and principle of nonmaleficence)and principles for application of medical ethics(including principle of informed consent,principle of medical service optimization,principle of medical service confidentiality and principle of life value).Section 4 mainly explores problems existing in China’s graded diagnosis and treatment system and causes of these problems.That takes Liaoning as an example.A main cause is that the above ethical principles are not well adhered to.To be specific,respect is lacking among doctors and patients for each other;fairness of medical resource allocation is inadequate and medical services have not yet been homogenized;medical institutions have not integrated the principle of public welfare in their operation,thus resulting in a low two-way referral efficiency,and some medical institutions are much too market-oriented,lacking regulations to effectively standardize their operation.Section 5 mainly points out the necessity of implementing the socialist humanitarianism so as to promote China’s graded diagnosis and treatment system construction.Full respect should be show to patients’ right of choice.The “guidance-cooperation” model can be adopted.Attention should be paid to practicability,feasibility and progressiveness of the system.The sweeping approach should be fully banned.During the process of informationalization,the principle of medical confidentiality should be fully stuck to both institutionally and technologically.A fair and just operation mechanism should be built.Fairness of resource allocation should be strengthened.Grassroots medical input should be increased.Private medical institutions should be encouraged to make up the shortage of grassroots medical resources through the “franchising” model in business management.China’s current medical insurance model should be further improved by increasing the reimbursement percentage of grassroots medical services.Fairness of medical services should be ensured;the basic medical service capacity should be strengthened;and the outstanding medical workers should be motivated to “work in areas with an urgent need of better medical services” and to further their study.Meanwhile,the public welfare nature of medical services should be further intensified,and the medical legal system construction should be further promoted.The ethical responsibilities of the government,medical institutions and individuals should be clarified.The government should take the main ethical responsibilities and keep on increasing the medical spending,particularly for health and disease prevention.Additionally,the medical insurance fund-raising structure should be optimized.The role of the government think-tank and the third-party evaluation and consultation institutions in managing and supervising medical institutions should be given full play to.The satisfaction degree of patients and doctors should be periodically investigated.Medical institutions should upgrade their medical service capacity by accelerating their informationalization and artificial intelligence construction.Innovation and entrepreneurship of medical services can be advocated in society and institutions of higher learning.The role of new media in popularizing knowledge of health and disease prevention should be further displayed.A favorable communication environment can be created with joint efforts of medical institutions and the society.Individuals should cultivate the awareness of health ethics and morality,holding themselves accountable for themselves,others and society,reducing waste of national medical resources,and increasing utility of medical resources.A reasonable and legitimate graded diagnosis and treatment system can be built to lay a solid foundation for construction of a basic medical and health services system with Chinese characteristics.The ethical research into China’s graded diagnosis and treatment system is insufficient.The existing research findings have not yet combined field survey of medical institutions and qualitative interview to investigate China’s graded diagnosis and treatment system construction from the perspective of basic and application principles of medical ethics.Therefore,exploration of the research gap represents a main originality of this research.