摘要
医患冲突通俗地说就是医生和患者双方存在的分歧、矛盾以至于出现侵犯对方合法权益的行为。从医患冲突实际情况看,医患冲突既源于不良医患关系,也源于医患需求没有得到充分满足。叙事医学由于突出情感关注、换位思考、医患关联,对调节医患关系、降低医患冲突发生的可能性有着独特优势,因而能够成为医患冲突的一个分析视域。从叙事医学的角度看,由人文关爱缺失、和谐沟通受阻、分歧难以弥合导致的医患鸿沟、医患矛盾和医患对抗是医患冲突的主要表现形态。多维度的叙事不足推动了医患冲突的形成和发展。“医者中心观”弱化了医生叙事的意识,“患者认知模糊”降低了患者叙事的能力,“医院形象独特”淡化了医院叙事的氛围,“制度供给困境”弱化了医学叙事的支持。为此,要增强医者叙事意识,弥合医患鸿沟;提高患者叙事能力,消除医患冲突诱因;营造医学叙事氛围,奠定良性医患关系基础;强化叙事医学支持,探索医患冲突解决新途径。在不同文化传统中,医患冲突生成和医学叙事都有其特殊性,如何从思维方式、价值取向和人生信仰等角度理解叙事医学并为解决医患冲突提供有效措施是当代中国维护人民健康需要进一步思考的命题。
In layman’s terms,doctor-patient conflicts refer to the existence of differences and contradictions between the doctor and the patient to the extent that the legitimate rights and interests of one part are violated.From the actual situation of doctor-patient conflicts,they are not only rooted in the poor doctorpatient relationship but also in the fact that doctor-patient needs have not been fully satisfied.Narrative medicine has unique advantages in regulating doctor-patient relationships and reducing the possibility of doctor-patient conflicts due to its emphasis on emotional concerns,transpersonal thinking,and doctor-patient association.Therefore,it can become an analytical perspective for doctor-patient conflicts.From the perspective of narrative medicine,the main manifestations of doctor-patient conflicts are the gaps,conflicts,and confrontations between doctor-patient caused by the lack of humanistic care,obstruction of harmonious communication,and difficulty in bridging differences.The insufficient multidimensional narrative has promoted the formation and development of doctor-patient conflicts.The“doctor-centered view”weakens the awareness of doctors’narratives,“patient cognitive ambiguity”reduces the ability of patients’narrate,the“unique hospital image”dilutes the atmosphere of hospital narrative,and the“institutional supply dilemma”weakens the support of the medical narrative.Therefore,it is necessary to enhance the narrative awareness of doctors and bridge the gaps between doctors and patients;improve patients’narrative ability and eliminate the causes of doctor-patient conflicts;create a narrative atmosphere in medicine and lay the foundation for a positive doctor-patient relationship;as well as strengthen the support of narrative medicine and explore new paths to resolve doctorpatient conflicts.In different cultural traditions,the generation of doctor-patient conflicts and medical narratives have their own particularities.How to understand narrative medicine from the perspecti
作者
江峰
林霁月
JIANG Feng;LIN Jiyue(Institute of Ultrasound Medicine,School of Medical Imaging,Wannan Medical College/Department of Ultrasound,the First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China;School of Marxism,Anhui Business College,Wuhu 241002,China;School of Marxism,Anhui Normal University,Wuhu 241002,China)
出处
《中国医学伦理学》
北大核心
2024年第11期1325-1330,共6页
Chinese Medical Ethics
基金
2021年度安徽省高校协同创新项目“人民生命健康视域中的诊疗环境正义问题研究”(GXXT-2021-047)。
关键词
叙事医学
医患冲突
生成逻辑
治理路径
narrative medicine
doctor-patient conflict
generative logic
governance path
