我国公众精神疾病病耻感问题的伦理思考及对策分析  

Ethical Considerations and Countermeasure Analysis of Public Mental Disorders Stigma in China

作　　者：屠月丽 张博源[1] TU Yueli;ZHANG Boyuan(School of Medical Humanities,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学医学人文学院,北京100069

出　　处：《中国医学伦理学》2022年第6期654-662,702,共10页Chinese Medical Ethics

基　　金：北京市社会科学基金项目“公共治理视野下北京市精神卫生法制问题研究”(15FXB029);北京市社会科学基金研究基地项目“再社会化视域下北京市精神残障者社会权利法治保障完善研究”(19JDFXA004)。

摘　　要：对精神疾病患者的歧视以及由此带来的病耻感,不仅会影响患者的就医行为,还会带来社区隔离和资源缺失,精神卫生问题已成为重大的公共卫生问题和突出的社会问题。从生命伦理学的视角来看,公众精神疾病病耻感的存在违背公正和尊重原则。通过定量描述公众精神疾病病耻感现状,并通过因子分析和二元Logistic回归分析探索公众精神疾病病耻感的影响因素。公众精神疾病病耻感得分为(54.64±11.048)分。因子分析提取4个公因子,分别为隔离、痛苦、接触、共情,累计解释方差68.948%。结果显示年龄、接触史是影响公众精神疾病病耻感的主要因素。建议通过增进了解、提高共情两方面减少歧视,具体来说是通过伦理规制和法治建设落实歧视个人责任以及营造“宽容”社会氛围,强化人类命运共同体理念,以实现公众安全与个人权益之间的恰当平衡。Discrimination against patients with mental disorders and the resulting stigma will not only affect patients'medical treatment,but also bring about community isolation and lack of resources.Mental health problems have become a major public health problem and a prominent social problem.From the perspective of bioethics,the existence of public mental disorders stigma violates the principles of justice and respect.This paper quantitatively described the status quo of public mental disorders stigma in China,and explored its influencing factors through factor analysis and binary logistic regression analysis.The public stigma of mental disorders score was(54.64±11.048).Factor analysis extracted 4 common factors,namely isolation,pain,contact,and empathy,with a cumulative explained variance of 68.948%.The results showed that age and contact history were the main factors affecting the public stigma of mental disorders.It is recommended to reduce discrimination by enhancing understanding and improving empathy.Specifically,it is to implement the personal liability for discrimination through ethical regulation and legal construction,and strengthen the concept of a community of shared future for mankind by creating a tolerant social atmosphere,so as to achieve an appropriate balance between public safety and individual rights and interests.

关 键 词：公众精神疾病病耻感 生命伦理原则 公众安全 人类命运共同体 

分 类 号：R-052[医药卫生]