The market economy, as a means of regulating economic operation, has the role of rational allocation of resources, automatic (two-way) regulation of supply and demand, objective value assessment and mandatory rewards for excellence and punishment of inferiority, which ultimately leads to the relationship of interests and their distribution, changes in the moral values, so that the economic development and ethical progress in the principle of distribution according to work to achieve consistency and order. In the construction of medical ethics is specifically manifested as follows:
(1) Competition incentive effect, help to promote the progress of medical ethics. Competitiveness is a significant feature of the market economy, especially the development of modern times, it is the commodity producers compete with each other to promote the rapid development of social economy, so that mankind collapsed into the era of social mass production. Competition implies that there is a survival of the fittest for every producer, and that every producer is required to make continuous progress. Moreover, the competitive nature of the market economy is injecting new vitality into the construction of medical ethics. Competition greatly stimulates the desire of medical institutions to occupy the medical market, prompting them to reform hospital management, increase investment in equipment, improve the level of medical technology and quality of medical care, improve the image of the hospital with a good service attitude, increase the competitiveness of the hospital in the medical market, to create the maximum economic benefits. Which hospitals have low level of medical technology, poor hospital management, poor service attitude, sitting at home waiting for patients, which hospitals will have a greater sense of crisis. Due to the introduction of competition mechanism in hospital management, so that a large number of top talent to stand out, medical and nursing staff, reform, upward mobility, learning science and technology, engage in scientific research, the development and application of new technological achievements, a powerful way to overcome the "pot rice" conditions can not be overcome under the irresponsibility of the work, eat three square meals a day, do not care about nothing, do not seek to have the merit to do, but not to avoid faults, and the hospitals will be able to create a greater sense of crisis. The phenomenon of being a monk for one day but not a bell for another day. At the same time, benign competition will inevitably prompt the main body of medical ethics to strengthen their own cultivation, strengthen the sense of self-discipline, standardize the behavior of medical ethics, improve the quality of service, in order to ensure invincibility in the competition.
(2) Market justice effect, help the coordination of medical relations. In the market economy, goods are born equal pie, which determines the equality of market relations. Anyone who participates in market activities is equal in the market, against any administrative, property and patriarchal privileges. They treat each other only as sellers or buyers of commodities, as owners of commodities and owners of money, and all other social distinctions are not recognized. In market buying and selling, the principle of equivalence prevails, the buyer and seller are required to receive and pay roughly equal value, and no one is allowed to take possession of another's labor through non-economic ways and means. It is now the market economy of equal opportunities and rights of all people, the negation of the feudal privilege of the concept of hierarchy, diluted the human factor in the market exchange, in the field of health care, conducive to meet the different levels of different levels of the population of different levels of health care needs, and contribute to the establishment of the autonomy of the relationship between the doctor and the patient, between doctors, and the equality of the relationship between the doctor and the patient.
(3) Value recognition effect, help the implementation of the principle of distribution according to labor. For a long time, by the influence of the planned economy, medical and health care is treated as welfare undertakings, mistakenly treating medical and health care institutions as the bearer of welfare institutions, while the state's allocation of medical institutions is very limited, which has led to the phenomenon of shrinking of medical institutions and reduction of the capacity of medical and health care services. The in-depth development of the market economy and medical and health services tertiary industry calibration and medical services market direction, help to overcome the "brain and body upside down" shortcomings, break the medical and health services pure public welfare, pure consumption of the concept of limitations, so that the main body of the medical ethics of the value of the materialization of the labor and living labor in the market can be recognized and balanced, respect for knowledge and talent concept can be strengthened, to break the concept of knowledge and talent. The concept of talent can be strengthened to break the "pot rice" phenomenon, to overcome the planned economic conditions of dependence on the idea of the real embodiment of the "more work, more pay, according to the distribution of labor" principle.
(4) The concept of catalytic effect, help the establishment of a new medical ethics system. The establishment of the market economy system triggered changes in the relationship between interests, making people's concept of pioneering and enterprising, the concept of fair competition, the concept of time efficiency, the concept of talent information, the concept of self-esteem, the concept of legal discipline, the concept of personal legitimate interests and so on is increasingly clear, thus forming an intangible and huge power of public opinion, the counter-action in the economic base, and to promote the development of the socialist market economy. The market economy emphasizes the utilitarianism of the subject of medical ethics, and requires the subject of medical ethics to improve economic efficiency while improving social efficiency, which triggers the chain updating of the concept of medical ethics and changes in the evaluation standards and evaluation methods of medical ethics, and even has a profound and far-reaching impact on all aspects of medical ethics education and construction, which also fully reflects the strong voice of the community.
2. Negative effect of market economy on medical ethics
The market economy, which aims at pursuing values and economic interests, is a means to realize the production purposes stipulated by the socialist economic laws. However, the pursuit of value in the market economy, but also lurks in certain conditions for the value of the sacrifice of the use of value and social interests, thus promoting the economic impulse, dilute the moral rationality, leading to or prompting the emergence of non-moral consciousness of the medical staff, behavior, style and development, and even produce a new worship of materialism and gold worship. Manifested in the dilution of the spirit of dedication, the concept of medical ethics, the proliferation of medicine for personal gain, the decline in the quality of medical services, and other social and moral level of a certain degree of "slippery slope". Specifically manifested in:
(1) the competitive nature of the market economy, may trigger the subject of medical ethics speculative psychology, resulting in a waste of health resources. Under the conditions of the market economy, competition has become a reasonable way for individuals and units to pursue their own maximum interests, is the law of value acting on the market economic activities indispensable regulating mechanism, but also inevitably cause a certain degree of spontaneous blindness, it is very easy to induce people's speculative mentality. Market competition is often to defeat rivals, the strong rise and fall of the weak and then achieve the exclusive purpose, the negative factors of this weak and strong always to this or that way to show tenaciously. When it affects the sacred temple of health care, there may be buying and selling patients, digging each other's corners, the phenomenon of "medicine for personal gain", or cause the duplication of local large-scale equipment purchases, in order to enhance competitiveness, to the already very lack of health resources to bring greater pressure.
(2) the utilitarian nature of the market economy is likely to promote the main body of medical ethics of gold worship and quick success and quick profit behavior. Utilitarianism is a major feature of the market economy, commodity producers always try to minimize the cost in exchange for maximum benefit, everything to whether to make money to measure right and wrong. Socialist market economy must also seek economic efficiency, although it implies the spirit of truth-seeking and efficiency, for medical and health institutions to increase revenue and save money, improve the level of operation, and strengthen the economic and material basis of hospital construction has an undeniable significant role. However, its negative impact should not be ignored, it may lead to medical institutions pay too much attention to economic benefits, to the point of obtaining the maximum profit as the only pursuit of the goal, while ignoring the social benefits; may only focus on the immediate interests of the neglect of specialty construction and business development, relaxing the cultivation of talents; may ignore the strict implementation of the medical system, affecting the quality of medical care; may be blindly accepting and fostering the individualism and egoism, leading to leadership and the development of the hospital's economic and material base. Egoistic thinking, resulting in tension between leaders and the led, between departments and departments, between hospitals and hospitals, between medical staff and between doctors and patients, conflicts and other undesirable conditions.
(3) the social openness of the market economy has grown the vacuum of medical ethics, there is a certain period of medical ethics disorder. This is the market "intermediary" role, people's activities and freedom of space and increase, breaking the existing order of medical ethics and non-moral phenomena increase the inevitable performance, but also the special interests of commodity production, is the starting point of commodity economic activities and the destination of this feature of the spontaneous tendency of the intrinsic characteristics of the regulations.
(4) the principle of equivalence of exchange in the market economy, increasing the materialization factor between doctors and patients, diluting the doctor-patient relationship. The doctor-patient relationship is based on the noble humanitarianism, which requires medical workers, "the same equal", "equal treatment", do not accept gifts, do not take bribes, wholeheartedly for the people. However, some units or individuals take the principle of "equal exchange" in the market economy as the fundamental principle in dealing with the doctor-patient relationship, forgetting that the real value of voluntary labor lies in health and life, neglecting the public welfare aspect of socialist medical ethics, treating it as a pure economic entity, and treating the doctor-patient relationship as a pure exchange of goods, with economic interests taking precedence over everything. The doctor-patient relationship is regarded as a purely economic entity, and the economic interests of the doctor-patient relationship are above all. In practice, the prominent manifestation of "quality and price", that is, who pay more money, send more gifts, or who can provide me with certain services, I provide to who the number of services on the quantity, quality is good. Otherwise, or "routine", or perfunctory, resulting in delays, and even major medical accidents.
(5) The intervention of the market mechanism, so that the medical services in the market is not well developed with objective monopoly. Medical and health units have become a relatively single "seller's market", the elasticity of consumption of medical demand is very small, doctors and patients are in an unequal position, the micro-benefit of medical services and macro-benefit also appeared major deviation, prevention and treatment of disease disconnect, "three-tier medical and health network "The utility of the network is greatly reduced.
In short, the erosion of gold worship under the market economy conditions has distorted the values of medical ethics; the misuse of the principle of equal exchange has misplaced the psychology of solicitation; the misguided concept of efficiency has inflated individualism; the impact of the second career has sharply reduced the motivation of workers; and the inadequate compensation mechanism has caused the management of ethical slippage. These are worthy of our attention and deep thought.