对农村医疗卫生服务网底的伦理现状研究.pdf

nullnull2352010M10SDChineseMedicalEthicsVo.l23No.5Oc.t2010null农村卫生伦理null对农村医疗卫生服务网底的伦理现状研究gHuL4s*王晓燕,吕兆丰*,彭迎春,彭null炜(nDSv35,n35,null100069)!K1通过对北京市H区的实地观察和访谈,深入研究并分析了农村医疗卫生服务网底的有别于城市的道德关系和道德现状b!1oM农村医疗卫生服务网底；实地观察；道德关系；道德现状；伦理现状研究!ms|R-052nullnullnull!DSMAnullnullnull!cI|1001-8565(2010)05-0063-04nullResearchandEthicalAnalysisontheStatusoftheBasicLevelofRuralHealthServiceSystem-BasedonFieldObservationinHDistrictinBeijingWANGXiao-yan,LVZhao-feng,PENGYing-chun,PENGWei(SchoolofHealthAdministrationandEducation,CapitalMedicalUniversity/CapitalResearchCenterofHealthManagementandPolicy,Beijing100069,China)Abstract:Theresearchcarriedoutinvestigationoffieldobservationandin-depthinterviewinHDistrictinBeijing,studiedandanalyzedthemoralrelationshipandmoralstatusofthebasiclevelofruralhealthservicesystemwhicharedifferentfromthoseinurbanareas.Keywords:BasicLevelofRuralHealthServiceSystem；FieldObservation；MoralRelationship；MoralStatus；EthicalResearchnullnullnDSv5F5,g|HuTC,8InhNa6a?Z$,VHu|CTaBaQT,sY2009M72009M12,5QHuL4b,2009M72083,3T=|7h,dT4LMZT,106h9hD4；2009M125FQHuL,3T=|33h3i,Y5ET4,h3i=|1hDL,33bH21?,gHu3T40h106h42hDL4,PjhD3rC1,1+y1Mb1nully1uYKA+,7=d331,1)7ibHu)v,2,_=Vub-,uqBaBaBa7B25Bb,49?C,uB,g95%PqBBV,qBa4QYBib,-4a=am3292h,7h3DhDH93h,hhhyTfTf73p8+y=11by53#1%MMW31&,%,9&b1yN,VBhD3,L=P&EVaD1b1.1null家庭婚姻道德关系中的村医Q4?C,S.d4Qh,Bth0F.dN；Hug32,2009Mu#0?b16b5Huhy)27+y,j33v,hr%,Bh0BBf($v)F,KPhhfW1,V79BMWTT,7B4QEV4Qb1763*:gn9%7y!9&(PHR200906118)；gS9(SZ200910025006)YTnullnullSnullDnullnullnullnullnull3T1,9%h34NT1b1.1.1nullhDhEVgBb442hDX,32hv,610hv,8hDfhvbV,hDhWT,B%i&1b1.1.2nullhD9hZsTfTfpb4$#%p3&H,hDhv4ET,hhDT1,MWM7&,#W3VY,%n&M1MVCb3,hDVhjL/,hDhBb=#,hD#EV94b1.3null医务职场道德关系中的村医,h3,W?3T,?31,t1PhD&B77,bPhDhMWEV353M1b7hD?31A1&+yb1.3.1nullhDgDgj&zbhDh3L=&z,gDgjbyN,BhDh?3bQ4,sY91b?ChDhMTTHW,1?,hDY*5P5,5j#E,7P*b7:30P3i；/16:3017:00/；?Y85V,9P,11:0014:00W,/15:0016:007,/16:00T,jVMJ3,TD3,3YVDh?3D1；Tj,YVaMa!h3b1.3.2nullhDHDb4A,h3i!h0,3i:,!hHO:b7O,h3iigD*/；6,hDyh0,DH1-Eb1,hh,hDE3i,hhDE；hEh5,hDhEb1.3.3nullhD&zP1pb,DTB,81p3aaZTZE#rrT%bhD&)jhD38,Zh3D,2T1h,ZTZEyhp7AB?aZT2,t81phDh3iF,HTfg7%b,hDh,MB3h=1AVz0+,vEh0QNTMiOFMWTfbr,hD3?Sb4+AhD64nullk,:jhD3CgHuL4sh3i,v,TAU&z,EL,PhTha8T,hAh,DfbV,hDWB%i&1,4NTaf$b4,hihDEH,45.3%hVUihD?；53.8%VUyhD1,1-EhDE1,?；BhVUihD?(nV2)bV2nullhihDEihDECTBQQhEhNhShBhKhYn(%)n(%)n(%)n(%)n(%)n(%)n(%)9n(%)i6(35.3)13(81.2)7(43.8)5(31.2)5(55.6)3(18.8)9(56.2)48(45.3)i0(0.0)0(0.0)0(0.0)1(6.2)0(0.0)0(0.0)0(0.0)1(0.9)?11(64.7)3(18.8)9(56.2)10(62.5)4(44.4)13(81.2)7(43.8)57(53.8)917(100.0)16(100.0)16(100.0)16(100.0)9(100.0)16(100.0)16(100.0)106(100.0)nullnullL=,4A,DW?,E,hDh5,h3i:fL,?；4?C,HhB)BtTshD?,%8I&5,hD9JrBhYb6,hDhWf1PD1B=1,=8Chp7T1,YhDD,PhMFyh7uY(nV3)bV3nullhD4DHhhuYuYCTBQQhEhNhShBhKhYn(%)n(%)n(%)n(%)n(%)n(%)n(%)9n(%)0(0.0)0(0.0)1(6.2)2(12.5)0(0.0)0(0.0)1(6.2)4(3.8)16(94.1)16(100.0)15(93.8)14(87.5)5(55.6)10(62.5)11(68.8)87(82.1)b#1(5.9)0(0.0)0(0.0)0(0.0)4(44.4)6(37.5)4(25.0)15(14.2)917(100.0)16(100.0)16(100.0)16(100.0)9(100.0)16(100.0)16(100.0)106(100.0)nullnullfa=1,hDhyf73lb,hhD,9%BZ4,Z&,L4?C,M8hD,?&SEhD800,!Eg,MVBE?D,y%*&；EhD,hT；0H,h,y%E0,s*bI!&2.2null医德义务与责任以血缘地缘为背景,OZ,AliblBaSEaEVk3bCL3,B1kKl:EplallblMMb-lMM1,Bl5fa4QSDM1bhhhD,Epll3q#EpE?,D3b=QL,33h3iD3f,?CTBhDEplli,yBhBBhD,vh9hDbNN=,LhDkEpll,AklbB#FL=B/iMbBhrBPtalaDMhD,kljA1b4A,hD+EMT,a,VnM,S%OD,hz,A&；hDhp,VS,sebZVkhDl,800TD13,YL,TVl1pl?,*hDV?3hb4AthDv3,ShDSY3l；vhDgDgj3h3,hD3e.kb,hD1-O7T1h1-&hBM&l3,?lP3hDk?T,9l:,vhD,gvDyD1f7PDt?i5H,jhD1?7b2.2.1nullD1MMbh,j,Ph%E&G,BmyaWTb9yN,h1EEVpDZT,E1-Db,hDT?hD_7D1b4NM1bby3TffaWW#P4NZ#Z1(/77:)65nullG,:CD7?ILarmIa!,7sQbS/H,!MS,DS,G/,46Sb!ID1null陈四军,陈姣芬.坚持以人为本,加强医院文化建设J.中国民康医学,2007,19(10):916-917.2null张书昌,郑亚东.卫生人力资源配置对医疗服务公平性影响的伦理思考J.中国医学伦理学,2009,22(5):79-81.3null戴立萍,郭吉雅,陈海兰,等.以人为本理念在医院人力资源管理中的应用和体会J.中华医院管理杂志,2006,22(1):36-37.4null窦文建.浅谈医院文化建设J.中华医院管理杂志,2007,23(5):10-12.5null陈柯柯.%无为而治&与现代医院管理J.中国医学伦理学,2008,21(1):120-123.!TeG(1969-),o,g,6=,VbZ_:6rIb!lnull2010-06-03!null2010-08-27!编nullnull辑null李恩昌(65:)b$,M8CBh4hD,DWoB?S,Vb,67.9%hhDYhZ(nV4)bVVVAVDWMMabV4nullhDTTCTBQQhEhNhShBhKhYn(%)n(%)n(%)n(%)n(%)n(%)n(%)9n(%)hDh11(64.7)10(62.5)12(75.0)13(81.2)5(55.6)10(62.5)11(68.8)72(67.9)hD1-%5(29.4)4(25.0)4(25.0)2(12.5)0(0.0)1(6.2)1(6.2)17(16.0)B0(0.0)2(12.5)0(0.0)1(6.2)2(22.2)1(6.2)4(25.0)10(9.4)b#1(5.9)0(0.0)0(0.0)0(0.0)2(22.2)4(25.0)0(0.0)7(6.6)917(100.0)16(100.0)16(100.0)16(100.0)9(100.0)16(100.0)16(100.0)106(100.0)2.2.2nullD1Mbh3hDh,P4NZgpY,4NsZEbH,hD3iahDE,%3bW&%DbW&,yN?h3,3,hD14N1bh+y+Y=bn5,hAhVlu|b4h3i4,?ChAhlu|H?3,lK3iXr1,BMllhJTll,9+Y4hMl,W,+9lbN,hD,%Tr,?n；?&6,64h,AhDu|VE,BQ10,l5；A15,l10,2lnZT4hD,9B4jhDV#bQ,VvbQ4106h,83h3ihDThD3(ThD3D),23VUNb#1,QTh1hDD.db4?C,D,|ThD3,v?D,Vi+EhsAh；hD,D,$gThD3(D),7OHuBB,b,9nhN4PbK,VzDb4,AhDD0,?9,0b,81.1%$4hhD9?Ah.7nhbVBthDDi,4N,DZL,hVhDD|zb5!ID1null黄建中.比较伦理学M.济南:山东人民出版社,1998:21,25.2null中共北京市委,北京市人民政府.中共北京市委北京市人民政府关于推进北京市农村基本医疗卫生制度建设工作的若干意见Z.京发20085号.3null杨益群.再造%病