以人为本建设医院文化

从医院文化的结构层次入手，以精神文化、制度文化、行为文化3个层次为切入点，具体阐述了在建设医院文化过程中如何贯彻“以人为本”的理念。首先立足实际，培育人性化的核心价值观和医院精神；二是建立健全人性化管理制度和对员工实行人性化管理；三是树立以病人为中心的服务理念和提供人性化的医疗服务。     

Health care rationing: can we afford to ignore euthanasia?

Explicit rationing decisions are being made to encompass a wide range of health care issues. Voluntary euthanasia has largely been excluded from this debate due to, in my view, the emotive nature of the issue. Euthanasia is an issue in which economists have been largely excluded and in which ethicists and philosophers dominate. It is the purpose of this paper to review the economic and ethical literature on euthanasia and to discuss their compatibility within the debate on euthanasia. The potential cost savings by the use of advance directives, do-not-resuscitate orders, and futile care withdrawal are then reviewed, as are the potential cost savings created by hospice care. As a conclusion, the ethical and economic arguments are then balanced to assess their compatibility. It is the contention of this paper that reducing medical care costs near the end of life should not be a taboo subject, and that rationing decisions could focus on an exploration of this area and the approaches to it, which are ethically justifiable and economically worthwhile. The introduction of a policy of voluntary euthanasia could have a large impact on the rationing of health care resources whilst also promoting patient choice and an arena for a more dignified death.     

Rationing health care to disabled people

Combining a political economic perspective with a case study approach, this paper examines the intent, process, and consequences of rationed care for disabled people under the U.S. managed care system. Two disabled persons were followed over a three‐year period as they sought care for major episodes relating to chronic depression and post‐polio syndrome. The findings illustrate a marked disparity between the concept and goals of rationed care and the experience of consumers of services. For these people, care is rationed at the service level and also in terms of restricted access to, and payment for, the care sought. This often results in inadequate treatment and inflated costs. These problems are due in large part to the competitive nature of the major stakeholders, institutional coalitions that work against patients, emphasis on profit maximisation, devaluing of the lives of disabled people and the weak bargaining position that disabled persons hold as consumers.