关怀伦理的介入:医患关系重构的新视角

The Intervention of the Ethics of Care:A New Perspective on Reconstructing the Doctor-patient Relationship

梳理有关学者的关怀伦理理论观点,并基于关怀伦理的相关思想对疾病状态下患者的特性(脆弱性、自主性和依赖性)进行分析,在此基础上,讨论目前医疗机构中主流医患关系模式理论(包括律法关系、家长制关系和自主决策关系)的局限性与不足,并将这类主流医患关系说纳入到基于关怀的医患关系之中,以重构适用于当前医疗行为模式和医疗行业现状、体现己他两利关怀思想的医患关系模式,最后阐述了基于关怀的医患关系中的“关怀”实践路径,包括引导性双向叙事、同情与移情以及关怀美德。

This paper reviews the theoretical perspectives of the care ethics and analyzes patient characteristics(vulnerability,autonomy and dependency)in disease states based on the ideas of care ethics.On the basis of the above,the limitations and shortcomings of current mainstream doctor-patient relationship theory(including legal,paternalistic and autonomous decision-making relationship)in medical institutions are discussed,and such mainstream doctor-patient relationship theory is incorporated into the care-based doctor-patient relationship,in order to reconstruct a doctor-patient relationship model that is applicable to the current medical behavior model and the current situation of the medical industry and reflects the caring thought of unification of self-interest and other-interest.Finally,the paper expounds on practice paths of care,including guided bidirectional narratives,sympathy and empathy,and caring virtue.