浅谈深化卫生改革中的思想政治工作

随着市场经济的发展，卫生改革的进一步深化，医务人员的政治观、道德观及价值观念发生了变化。有的医疗卫生单位削弱了思想政治工作，放松了医务人员的职业道德教育，实行“救死扶伤，实行革命人道主义”的医疗准则倾斜，结果造成医德医风和医疗质量下降，影响了医疗卫生单位和白衣天使在群众中的形象。实践证明，深化卫生改革，必须加强思想政治工作。l加强党的领导加强党的领导首先是加强班子建设，坚持民主集中制原则，改善领导班子和政工人员的整体素质。领导班子团结配合，才能保证改革的顺利进行、加强党的领导，就是要加强对党员和…     

当前医德建设存在的主要问题与对策

当前医疗行业医德建设存在的主要问题：部分医务人员价值取向错位；医务人员服务意识不够；出现医务人员自我保护性医疗现象。究其原因有：医德建设缺乏制度保障；医院在市场经济中自身面临着生存问题；卫生行政部门对医疗机构缺乏有效的监督和考评；医务人员的劳动报酬不能体现医疗工作的高技术风险性；医患双方存在着严重的信息不对称；医学教育课程设置缺乏社会人文学科。为此，要加强制度建设，为医德建设提供保障；树立“以人为本”的理念，内化医德；强化法律意识，以法治德；建立有效的医德考评制度。     

对构建医疗职业道德体系的思考

医德体系应当由医务人员的工作责任心、医疗技术的严谨科学性和全体医务人员的新型服务观三个部分组成。医务人员的工作责任心是医德建设体系的基石,奠定了卫生职业道德体系的基础,这个基石越坚实,医德建设体系就越稳固。医疗技术的严谨科学性是医德体系的支柱,构筑起卫生职业道德体系的框架,医德体系靠精益求精的医疗技术所支撑。全体职工的新型服务观是医德建设体系的内核,决定着卫生职业道德体系的本质,具备了这个内核,医德体系将不断自我更新完善。     

对医疗卫生事业中不良现象的认识和解决途径

当前，在医疗卫生行业中，部分医务人员思想混乱，对改革存在错误认识，在医疗行为中出现违反医德的行为。这些现象的出现，除当前社会环境对医务人员潜移默化的影响外，也和当前某些不当宣传与引导失误有关。本文分析不良现象产生的原因，提出解决的办法。作者认为，要想较好地解决医务人员的不良现象，应该对医务人员加强医疗改革方面的下面教育，加强社会主义医疗道德和传统优秀的医疗道德教育，防止对一般的医务人员过多或偏激的     

卫生改革与市场经济

近年来,卫生事业发展很快,其主要原因就是卫生事业的管理方式和管理方法进行了改革,这场改革在总体上是成功的,是符合社会主义政策和医德标准的,因而促进了卫生事业的发展,提高了医疗质量,改善了医务人员的生活水平,受到了广大医务人员的拥护。但是,卫生改革也是一个在探索中不断完善的历史过程,改革中也有许多困难和不足。主要表现在对卫生改革的目的和卫生事业的性质缺乏深刻认识,忽视了思想教育和医德医风教育,缺乏在卫生决策和卫生管理中医德导向的论证和管理,不恰当地照搬企业管理经验和做法,以致造成医疗眼务商品化的倾…     

医德考核评价体系构建研究

医德，即医务人员的职业道德，是医务人员在医疗执业活动中所应当遵循的行为准则和规范，是医务人员应具备的思想品质，是医务人员与病人、社会以及医务人员之间关系的总和。一个医务人员医德的好坏，不仅与医务人员的形象息息相关，而且关系到医疗机构的声誉，关系到卫生行业的形象。因此，有必要建立科学合理的医德考核评价指标体系，切实加强医务人员的考核评价。而如何对医务人员的医德进行科学地考核评价，是卫生管理部门研究的热点和难点。本文试就医务人员的医德考核评价进行探讨，以探索建立科学合理的医德考核评价体系，为进一步提高医德医风建设水平提供有益参考。     

推行医德考评制度是提高医疗护理服务质量的有效途径

为加强医德医风建设，提高医务人员职业道德素质和医疗服务水平，襄州区人民医院自2009年开始对所有在职的医务人员试行医德考评制度。几年的实践证明，执行这项制度，不仅规范了医疗服务行为，树立了行业新风，而且还提高了医疗服务水平，和谐了医患关系。本文就有关医德考评方法、考评内容、结果应用和粗浅体会与大家交流。     

谈医院法人行为的医德倾向

在卫生改革大潮中,作为卫生事业法人的医院,其行为有哪些特征,其医德有哪些倾向,这是一个应当引起卫生行政机关和卫生管理干部普遍关注的重要课题。以往,人们对组成医院法人的自然人——医务人员的医德修养和医疗作风的研究     

加强医德医风建设,促进医院健康发展

医德 ,即医务人员在职业活动中应具备的思想品德 ,是医务人员与病人、社会以及医务人员之间关系的总和。尽管各级卫生主管部门颁发、制定了明确的规范 ,但是一些医疗单位仍然出现了服务质量下降 ,接待患者不主动热情 ,损害患者利益 ,索要好处等医德医风滑坡现象。滑坡的原因何在 ,新形势下有无加强医德医风建设的必要性 ,如何加强医德医风的建设 ,这是一系列令人深思的问题。1　医德医风滑坡的原因分析医德医风滑坡的原因可谓错综复杂 ,既有主观原因又有客观原因 ,既有内部原因 ,也有外部原因 ,其主要原因是1·1　医院思想政治工作弱化 ,观…     

“医德档案”该谁来写

近日，山西省卫生厅拟定的《关于实行医务人员医德考评制度实施办法（试行）》（讨论稿）中提出，该省将加强医德医风建设，建立对医务人员规范有效的激励和约束机制，为每一位医务人员设立“医德档案”，提高医务人员职业道德素质和医疗水平。     

Undergraduate ethics teaching: revisiting the Consensus Statement

OBJECTIVE: To determine whether the recommendations of the Consensus Statement published 7 years ago have been implemented. DESIGN: Postal questionnaire survey of 28 UK medical schools. METHODS: A survey was sent to the lead individual for teaching and learning at each medical school. This questionnaire inquired about the undergraduate ethics and law curriculum, including its design, teaching, assessment, staffing, and individuals' hopes and concerns for the future. MAIN OUTCOME MEASURES: Information relating to undergraduate ethics teaching in UK medical schools. RESULTS: Significant changes in the teaching and assessment of medical ethics and law that could be directly attributed to the Consensus Statement were identified. Whilst most schools covered all 12 recommended topics in their curriculum, only 3 felt all the topics were covered thoroughly and 3 schools said at least 1 topic was not covered at all. Only 16 schools identified 1 or more full-time academics who took direct responsibility for ensuring undergraduate medical students learnt about ethics; these were usually at lecturer grade. CONCLUSIONS: The Consensus Statement has had a significant impact on the teaching of undergraduate ethics but, even 7 years on, not all its recommendations have been implemented fully.     

The Internet doctor and medical ethics Ethical implications of the introduction of the Internet into medical encounters

In this article, consultation via the Internet and the use of the Internet as a source of medical information is examined from an ethical point of view. It is argued that important ethical aspects of the clinical interaction, such as dialogue and trust will be difficult to realise in an Internet-consultation. Further, it is doubtful whether an Internet doctor will accept responsibility. However, medical information via the Internet can be a valuable resource for patients wanting to know more about their disease and, thus, it is a means to enhancing their autonomy. This revised version was published online in July 2006 with corrections to the Cover Date.     

重大自然灾害应急医疗救援探析

现代医学伦理的核心原则（即自主原则、不伤害原则、行善原则和公正原则）,在处理医务人员与患者之间的伦理关系中发挥了重要作用,但在应对重大自然灾害时,则表现出明显的局限性。本文具体分析了现代医学伦理的四个核心原则,与重大自然灾害应急医疗救援中伦理关系的冲突,并提出对医学伦理关系的判断,不仅要立足于患者的价值取向,还要依据医务人员的价值判断和资源利用的效益评估,从而构建更加科学合理、和谐有序的医学伦理关系。     

浅谈如何加强医学生的医德教育

目的:通过医德教育,提高医学生的医德素质.方法:将医德教育融于教学之中,言传身教,结合实际,学生与教师相互配合,共同完善.结果:通过学习,学生树立了正确的人生观、价值观,以高尚的医德和精湛的医技走向神圣的医疗岗位.结论:将医德教育融于教学之中,是切实可行的,效果明显.     

医德医风信息化考评体系的构建与运用

运用现代高科技信息手段,结合本院实际情况,充分利用现有资源,通过窗口式、壁挂式、手持式评价器及医德医风评价系统与医德医风考评系统,形成一套完整的,信息化的,科学、便捷、客观、有效的,多维的评价考核体系,同时借助本院行政命令、法规、制度等运行机制,充分运用到医院管理中,旨在提升本院医务人员的服务质量,减少医患纠纷。     

我国知情同意原则的医学实践状况分析

借助《中国生物医学文献光盘数据库》对国内近10年来有关知情同意的医学文献进行了统计。从文献的年代、期刊、区域、学科及内容分布等角度分析了知情同意原则在中国的医学实践状况。归纳了一些有代表性的观点，并就知情同意在我国的应用和发展趋势提出了看法。认为医患关系观念的转变、公民权益意识的建立、相关法律条文的明晰和可操作性是知情同意原则实施的必要条件。     

Teaching medical ethics: A review of the literature from North American medical schools with emphasis on education

Efforts to reform medical education have emphasized the need to formalize instruction in medical ethics. However, the discipline of medical ethics education is still searching for an acceptable identity among North American medical schools; in these schools, no real consensus exists on its definition. Medical educators are grappling with not only what to teach (content) in this regard, but also with how to teach (process) ethics to the physicians of tomorrow. A literature review focused on medical ethics education among North American medical schools reveals that instruction in ethics is considered to be vitally important for medical students. Agreement by medical educators on a possible “core curriculum” in ethics should be explored. To develop such a curriculum, “deliberative curriculum inquiry” by means of a targeted Delphi technique may be a useful methodology. However, the literature reveals that medical curricular change is notoriously slow. General implications for medical ethics education as a discipline are discussed. This revised version was published online in July 2006 with corrections to the Cover Date.     

Flexner's ethical oversight reprised? Contemporary medical education and the health impacts of corporate globalisation

BACKGROUND: Abraham Flexner's famous reports of 1910 and 1912, Medical Education in the United States and Canada and Medical Education in Europe, were written to assist the development of a positive response in university curricula to a revolution in understanding about the scientific foundations of clinical medicine. Flexner pointed out many deficiencies in medical education that retain contemporary resonance. Generally underemphasised in Flexner's reports, however, were recommendations promoting a firm understanding of and commitment to medical ethics as a basis of medical professionalism. Indeed, Flexner's praise for the scholastic basic of German medical education appeared somewhat ironic when the ethical inadequacies of prominent Nazi doctors were revealed at the Nuremberg Trials. CORPORATE GLOBALISATION AND ITS IMPACT ON MEDICAL PROFESSIONALISM: This article suggests that contemporary medical educators, like Flexner, may be at risk of inadequately addressing a major challenge to evolving medical professionalism. Medical ethics, health law and even the international right to health are now increasingly emphasised in medical curricula. The same cannot be said, however, of lobbying principles arising from the structures of corporate globalisation, although these are rapidly becoming an even more dominant force in shaping medical practice around the globe. Conclusion Today it is the normative tension between medical ethics, health law and international human rights on the one hand and the lobbying principles and strategies of corporate globalisation that must urgently become the focus of major recommendations for reshaping the teaching of medical professionalism. Suggestions are made as to how this might practically be achieved.     

加强他律自律提高军队医院医德建设

利用古典哲学中他律、自律对立统一的原理,通过对医德建设、维系的论述,把医德他律、医德自律在军队医院医疗服务中有机结合起来,使之成为一个多元化、多类别、多层次、可操作的医德规范和价值体系辅以激励、约束、认同等措施,实现医德维系。     

医疗纠纷防范探讨--临床试验中应注意的问题

医疗纠纷发生的多种因素已经引起医务界的重视，但临床试验的问题尚未得到足够的关注。针对目前临床试验的不规范可能引发医疗纠纷甚至刑事案件的现状，提出应该注意的问题：（1）临床试验必须慎重选择，严格审批；（2）临床试验必须遵照医学伦理学和法规的要求；（3）临床试验必须严格覆行知情同意的原则。