医患双方“集体无意识”现象的剖析及破解对策——从追求“最优解”,到争取“满意解”  

Analysis and Strategy of the“Collective Unconsciousness”between Doctors and Patients:From Pursuing“Optimal Solution”to Striving for“Satisfactory Solution”

作　　者：何裕民[1] 

机构地区：[1]上海中医药大学基础医学院,上海201203

出　　处：《医学与哲学（A）》2016年第1期1-5,10,共6页Medicine & Philosophy:Humanistic & Social Medicine Edition

基　　金：2012年度国家社会科学基金重点项目;项目编号:12AD2094

摘　　要：分析了医疗领域积极诊查、过度治疗等问题,认为这是医患双方的集体无意识行为,其表现众多,驱动因素复杂,在肿瘤领域问题尤为严重,表现在过度追求筛查,热衷于创伤性治疗,习惯于滥用靶向药等最新治疗,且只追求最优结局。集体无意识的促成因素众多,包括对健康及生命的注重,科学主义的盛行,认为医学就是纯粹的科学,凡科学总有解决的办法,且完美主义作祟等思潮,都是背后的思想理路。最后提出,破解方法之一是倡导用争取"满意解"来替代追求"最优解",很多情况下,应推广"够好了就可以了"的决策思维。This paper analyzed and argued that the problems of positive diagnosis and over-treatment were the results of the collective unconscious between doctors and patients. It is a multi-factor phenomena expressed in numerous ways. Particularly in the care of cancer, the problems of over using screening and aggressive interventions are more serious. People are used to take new therapy like targeting drugs and only expecting for the best outcome. However, there are many factors contributing to the collective unconscious, including the over focus on the health and life, the prevalence of seientism, the thought of medicine is pure science which always has solutions and the excessive pursuit of perfectionism. Finally, the author claimed that one of the strategies was to advocate ＂satisfactory solution＂ rather than ＂optimal solution＂, and in many cases the thought of ＂good enough＂ should be promoted.

关 键 词：过度诊断 过度治疗 癌症 最优解 满意解 

分 类 号：R273[医药卫生—中西医结合] R-05[医药卫生—中医肿瘤科]