患方在危重临床决策中的地位探讨

当前紧张医患关系下,危重临床决策中医患冲突不断。根据患方在临床决策中的地位差异而有不同的决策模式,具体表现形式有三种模式:家长式决策、知情决策和共享决策。家长式决策已经不符合社会发展的需求,知情决策存在现实的操作困境,尤其在危重临床决策关头。共享决策模式是当前国际上临床决策的发展趋势,随着我国《侵权责任法》的实施,构架患者临床决策中的地位和作用应注重"科学与人道,合情与合法"的原则,保证一种动态平衡。

Analysis on the position of patients in critical clinical decision-making

Under the present tense doctor-patient relationship situation,there are lots of conflicts between doctors and patients in critical clinical decision-making.According to the position of patients in clinical decision-making,there are three decision-making models,including paternalistic decision-making,informed decision-making,and shared decision-making.Paternalistic decision-making does not meet the development needs of the society.Informed decision-making faces with lots of practical troubles in the real operation,especially in severe clinical decision-making.Shared decision-making model is the current trend in clinical decision-making all over the world.With the implementation of "Tort Liability Law" of China,we should re-structure the position and role of patients and keep the dynamic balance between doctors and patients,in the principle of "Scientific and humane,fair and legitimate".