医患利益冲突及其平衡

The Conflict of Interests between Physician and Patient and Its Management

在现代语境下,利益冲突是对医患主体身份的认可与利益多元的表达,而成为考察医患关系的重要向度。制度性的经济利益冲突、个体性的合法权益冲突以及潜在性的价值冲突成为医患利益冲突的主要表现形式。医疗职业化催生了医务人员职业角色与私人角色的分化,价值判断的多元化成为利益冲突发生的道德根源,而医疗市场化改革成为利益冲突的制度性原因。重新审视医患关系本质成为利益平衡的关键,利益平衡强调医患双方利益的合理性,是对双方利益的公平表达,从而有利于医患利益冲突的解决。为此,医改设计中需要平衡医患双方的合法权利,平衡双方的经济利益表达,并注意保护医务人员的合法利益。

In the modern context,the conflict of interests explicates the identification and multi-interests of the physicians and patients,and it has become an important dimension to inspect the physician-patient relationship(PPR).Institutional conflict of economic interests,individual conflict of legitimate rights and interests and potential conflict of values have become the main manifestations of conflict of interests between physicians and patients.Medical professionalization produced the differentiation between the professional role and private role of medical professionals.The diversification of moral judgment is the moral root of conflict of interests,and the medical marketization is the institutional cause of conflict of interest.Reexamine the nature of PPR is the key to the balance of interests,which emphasizes the rationality of both patients and physicians'interests,and fairly expresses their interests.Therefore,in the design of medical reform,it is necessary to balance the legal rights of both physicians and patients,and balance the economic interests of both parties,especially the the legal interests of medical professionals.