公共卫生视域中的病人自主权问题探析

Analysis of Patient Autonomy in the Perspective of Public Health

20世纪中后期,病人自主权的确立使得医疗行为中主体权责划分日渐清晰,医疗决策的过程逐渐规范化。然而在医疗实践中,人们也意识到病人自主不是绝对的、无条件的原则,并开始探讨何种情况下可以对病人自主进行限制。从对病人主体形象的重构中指出个人利益与公共利益在价值层面的一致性,强调在公共卫生事件的处理中医生决策权的必要性。在医疗社会化和全球化的背景下,公共卫生危机的化解、公民道德共识的达成,有赖于病人、医生、社会及国家间的共同努力。

In the mid-to-late 20th century,the establishment of patient autonomy made the division of authority and responsibility in medical practices increasingly clear,the process of medical decision-making was gradually standardized.However,in medical practice,people also realized that patient autonomy was not an absolute and unconditional principle,and began to explore under what circumstances patient autonomy could be restricted.This article points out the consistency of personal interest and public interest from the reconstruction of the patient's subject image,emphasizes the need for doctors'decision-making in the handling of public health events.In the context of medical socialization and globalization,the resolution of the public health crisis and the achievement of civic moral consensus depend on the joint efforts of patients,doctors,society and the country.