医患沟通中疾病认知模式的伦理审视

Ethically reviewing the cognitive mode of diseases in doctor-patient communication.

医患沟通中双方对疾病的认知存在较大差异,分别可得到相应的伦理辩护,却存在着知情同意与屏蔽、怀疑共存,医疗保密与伪装、公开兼容,尊重生命与低估、忽视相伴等方面的伦理冲突。在医学行善总原则下,通过求同存异中的医患互动,多方参与下的医患谈判,以病人为中心的医患决策的伦理抉择,可以实现疾病认知差异下的良性沟通。

Objective：There exist different cognitions on diseases between doctors and patients in doctor-patient communication,which attains corresponding ethic defense respectively. However, ethical conflicts still exist in many aspects, such as coexis- tence of patients＇ right to informed consent with information shield and patients＇ suspicion, compatibility of confidentiality and disguise and reveal, respecting and ignoring patient＇s life. Following the general principles of medical charity, positive doctor-patient communication can be achieved in ethical choices of patient -centered medical decision-making, which is by doctor-patient interaction through seeking common ground, muhi-party negotiations between doctors and patients.