从个体信任到制度信任——医患信任的制度审视与重构

From Individual Trust to Institutional Trust:An Institutional Examination and Reconstruction of Doctor-Patient Trust Relationship

当前中国医患信任关系正从个体信任向制度信任转变,呈现为一种个人经验难以直接检验、建立在抽象系统之上的社会心理,它既与医生的个人品德相关,更与社会制度的建立和健全直接勾连。医患信任的匮乏是医患关系紧张的表征和病症,根源于市场化变革带来的配套制度滞后,并且受到整个社会信任生态的负面影响。在信任匮乏的背景下,主体之间的博弈和互动需要付出较大的成本,且容易带来多方受损的后果。抓住制度建设这一根本,以公正性的理念来健全和完善制度,以相关主体的权责来改进制度,建立有效的监督制度是重构医患信任的制度路径。

The doctor-patient trust relationship is transforming from individual trust to institutional trust in current China. As a social mental phenomenon based on the social system beyond the personal experience, it is not only connected with the doctor＇s private virtue, but also has a close relationship with the establishment of social constitution. The lack of trust between doctors and patients is the reason as well as the result of the tension between doetors and patients, which is rooted in the lag of related regulations in the process of market reform and influenced by the negative moral phenomenon. For lack of trust, the interaction between the main players has to pay a higher cost, which tends to bring about double loss. To grasp the critical factor of the construction of system, to improve and perfect the system with the concept of fairness and the rational allocation of duties and responsibilities between the main bodies, and to establish an effective system of supervision are the means to reconstruct the system of trust between doctors and patients.