摘要
从患者、家属、医生三方参与医疗决策的理论依据出发,对医患共同决策过程中决策权利配置的公平与效率问题进行了探讨。首先对三方决策权的主要争议进行了辨析,然后设计出权责对等和社会关照等可操作的医疗服务决策权配置原则,进而提出明确权利行使顺序、规范权利制衡机制、提高医疗决策能力等优化医疗服务决策权配置的对策。认为患者最佳利益的第一守护者是患者本人,家属和医生是居于补充地位的第二守护者,而公权力的执掌者是居于最后一道防线的第三守护者。
Based on the theoretical basis of the participation of patients, family members and doctors in medical decision-making, the equity and efficiency of allocation of decision-making rights in the process of doctor-patient shared decision-making were discussed. Firstly, the main disputes of the decision-making rights between patients, family members and doctors were analyzed. Then, two operational principles of allocating the right of medical decision-making were presented, namely, principle of right being equal to responsibility and principle of helping the vulnerable groups. At last, three suggestions were proposed to optimize the allocation of the right, which were clarifying the order of exercising the rights, enacting mechanism of rights balancing, and enhancing the medical decision-making ability. In conclusion, the first guardian of the patient's best interests was the patients themselves. Family members and doctors were supplementary guardians. And the holder of public power played the role of the last-ditch protection of the interests of patients.
作者
何岚
郑美雁
HE Lan;ZHENG Mei-yan(School of Culture and Social Development,Southwest University,Chongqing 400715,China)
出处
《医学与哲学》
2019年第18期7-10,17,共5页
Medicine and Philosophy
基金
2019年国家社会科学基金一般项目(19BRK017)
关键词
共同决策
医疗决策模式
决策权
shared decision-making
medical decision-making model
right to make decision
