不同互联网医院运营模式下的医学伦理挑战与对策

Medical Ethics Challenges and Countermeasures under Different Internet Hospitals Operation Modes

新冠肺炎疫情防控期间,互联网医院在满足患者就医需求方面发挥了巨大的作用。作为新的服务模式,也带来了医学伦理的新挑战。通过行为者、行为过程和行动结果三个行为关键要素分析,发现:除医疗安全、数据安全、隐私保护等伦理挑战外,不同类型互联网医院因涉及的行为者不同,表现出差异化。第一类互联网医院表现为线下工作模式与线上工作模式融合中带来的医生利益冲突;第二类互联网医院表现为公立医疗机构医务人员提供个性化服务需求带来的就医公平性挑战;第三类互联网医院表现为开放平台环境下技术水平良莠不齐的医生行医带来的医疗安全挑战。结合目前科技伦理治理和社会数字化转型,提出进一步明晰互联网平台相关主体权责界限、制定互联网医院医务人员行为规范要求、监督医生互联网医院行医行为等对策和建议。

Internet hospitals played a huge role in meeting patients medical needs during the COVID-19 pandemic.As a new service model,it also brings new challenges to medical ethics.This paper analyzed the three key elements of behavior:actors,behavior process and action result,and found that apart from ethical challenges such as medical security,data security and privacy protection,different types of Internet hospitals show diversity due to different actors involved.The first type of Internet hospital represented the conflict of interest of doctors brought by the integration of offline and online working modes.The second type showed the challenge of fairness in medical treatment brought by the demand of personalized service provided by medical staff in public medical institutions.The third type manifested the medical security challenges brought by doctors with varying technical levels in an open platform environment.Combined with the current ethical governance of science and technology and the digital transformation of society,this paper put forward some countermeasures and suggestion,such as further clarifying the boundaries of rights and responsibilities of relevant subjects of Internet platform,formulating the code of conduct requirements for medical staff in Internet hospitals,and supervising doctors medical practice in Internet hospitals.