医患沟通困境:患者角色客体化和医患关系工具化  

The Dilemma of Doctor-patient Communication:Objectification of Patient Role and Instrumentalization of Doctor-patient Relationship

作　　者：刘洁 LIU Jie(College of Humanities and Social Sciences,Taiyuan University of Science and Technology,Taiyuan 030024,China)

机构地区：[1]太原科技大学人文社科学院,山西太原030024

出　　处：《中国医学伦理学》2022年第11期1241-1245,共5页Chinese Medical Ethics

基　　金：太原科技大学来晋工作优秀博士奖励资金“现代性视域下当代女性的生活叙事及其机制研究”(W20202001);太原科技大学博士(后)科研启动基金“城市活力老人照料负荷下的社会参与研究”(W20202004);山西省社会科学院(山西省人民政府发展研究中心)2021年度规划课题青年项目“城市低龄老人社会参与的现状及对策研究”(YWQN202147)。

摘　　要：医患沟通需要医患双方的相互信任、彼此尊重、共同参与,医患沟通的困境体现在患者角色客体化和医患关系工具化两个方面。一方面,狭隘实证主义导致见“病”不见“痛”的诊疗惯例,患者被剥夺了诉说和解释的主体性,在医学技术理性主义之下,专业术语规范健康认知,通过选择性加工和选择性呈现,患者的个性化经历转译为标准化病历,导致了患者角色的客体化;另一方面,消费社会使医患关系成为基于交换的非人性化服务,技术医学则使医患关系无视情感和人性的叙事,导致了医患关系的工具化。复元理念和实践鼓励患者重新寻找到生命的意义与价值,复元模式的出发点与“生物-心理-社会”医学模式的宗旨相一致,复元模式的核心是重拾医学的人文属性,推广复元话语和项目有利于破解医患沟通困境,构建医患共同体。Doctor-patient communication needs mutual trust,mutual respect and joint participation,and the dilemma of which is embodied in objectification of the patient role and instrumentalization of the doctor-patient relationship.On the one hand,narrow positivism leads to the diagnosis and treatment practice of seeing disease without pain,in which the patient is deprived of the subjectivity of telling and explaining.Under the rationalism of medical technology,professional terms regulate health cognition,through selective processing and presentation,the individualized experience of the patient is translated into standardized medical records,which leads to the objectification of the patient role.On the other hand,the consumptive society makes the doctor-patient relationship become an dehumanization service based on exchange,while the technical medicine makes the doctor-patient relationship ignore the narrative of emotion and human nature,leading to the instrumentalization of the doctor-patient relationship.The concept and practice of recovery encourage patients to rediscover the meaning and value of life,and its starting point is consistent with the aim of bio-psychological-social medical model.The core of recovery model is to regain the humanistic attribute of medicine,and promoting recovery discourse and projects will help to solve the dilemma of doctor-patient communication and build doctor-patient destiny community.

关 键 词：医患沟通 患者角色 医患关系 

分 类 号：R197.32[医药卫生—卫生事业管理]