(1) Legally speaking, the doctor-patient relationship is a medical contractual relationship.
(2) Ethically speaking, the doctor-patient relationship is a trust relationship.
Doctor-patient relationship model
From 65438 to 0956, American doctors ThonsasSzasa and MareHollender published the Basic Model of Doctor-patient Relationship in Achievements of Internal Medicine. According to the initiative of both doctors and patients in the decision-making and implementation of medical measures, it can be divided into active-passive mode, guidance-cooperation mode and * * * participation mode.
1. Active-passive mode In this mode, doctors and patients do not act in two directions, but doctors act on patients in one direction. Doctors are in the active position, patients are in the passive position, and obedience is the premise. This model is suitable for patients with coma, shock, psychosis, severe mental retardation, infants and other patients who are difficult to express their subjective wishes. This model is similar to the relationship between parents and babies, and the doctor's duty is "what to do for the patient". Although this is conducive to the initiative of doctors, it is not conducive to the initiative of patients with independent ability. Lack of understanding of patients' feelings, complaints and other information may affect the diagnosis and treatment effect, and even lead to misdiagnosis and mistreatment.
2. Guidance-cooperation mode In this mode, the patient, as a conscious and thoughtful person, has certain initiative, can actively inform the illness, reflect the diagnosis and treatment, and cooperate with the examination and treatment. But there is no objection or opposition to the doctor's diagnosis and treatment measures, and the doctor is still authoritative and still in a dominant position. This model is suitable for most patients. Similar to the relationship between parents and teenagers, the doctor's duty is to "tell patients what to do". Compared with the active and passive mode, this mode is helpful to give full play to the enthusiasm of patients and improve the diagnosis and treatment effect, and it is also a more widely used mode.
3.* * * Participation Mode In this mode, both doctors and patients have roughly the same rights and participate in the decision-making and implementation of medical programs. This model is suitable for patients with chronic diseases who have a certain medical knowledge background or a long time. Similar to the relationship between adults, the doctor's duty is to "help patients treat themselves". Theoretically, this model is the most ideal, which can not only improve the level of diagnosis and treatment, but also help to establish a harmonious relationship between doctors and patients. However, not all patients have the ability or willingness to participate, and even patients with autonomy are often difficult to really implement because of the lack of necessary medical knowledge.
Moral rights and obligations of both doctors and patients
Moral rights and obligations of medical staff
1. The moral rights of doctors are the legal rights that doctors enjoy morally in medical activities. Generally speaking, legal rights are moral rights, and moral rights are not necessarily legal rights, but may also be the ideal of legal rights. Legal rights are mandatory, and some legal rights may not conform to specific moral norms; Moral rights are not mandatory or only weakly mandatory, which can be used as the basis for defending legal rights and sometimes can be used to criticize legal rights.
According to the Law of People's Republic of China (PRC) on Medical Practitioners, doctors have the following rights in their practice: ① To carry out medical examination, disease investigation and medical treatment within the registered scope of practice, issue corresponding medical certificates, and choose reasonable medical treatment, prevention and health care schemes; (2) According to the standards stipulated by the health administrative department of the State Council, obtain the basic conditions of medical equipment equivalent to my practice activities; ③ Engaged in medical research and academic exchanges, and participated in professional academic groups; (four) to participate in professional training and receive continuing medical education; ⑤ Personal dignity and personal safety are inviolable in practice; ⑥ Receive wages and allowances and enjoy the welfare benefits stipulated by the state; ⑦ Put forward opinions and suggestions on the work of medical treatment, prevention, health care and health administrative departments of medical institutions, and participate in the management of medical institutions according to law. The above is not only a doctor's legal right, but also his moral right. In addition, doctors also have the moral right to ask patients and their families to cooperate with diagnosis and treatment, and to interfere with patients' behavior under special circumstances.
2. Doctors' Moral Obligations According to the Law of People's Republic of China (PRC) on Medical Practitioners, doctors should perform the following obligations in their practice activities: ① Abide by laws and regulations and abide by technical operation norms; (2) Establish professionalism, abide by professional ethics, perform the duties of doctors, and serve patients with due diligence; ③ Care, love and respect patients and protect their privacy; (4) study hard, update knowledge and improve professional and technical level; ⑤ Promote health care knowledge and provide health education for patients. The above is not only a doctor's legal obligation, but also a medical ethics obligation. In addition, the doctor's moral obligation also requires that the obligation to patients should be unified with the obligation to others and society, and the rights of patients should also be regarded as due obligations.
Moral rights and moral obligations of patients
1. Mental rights of patients Patients have equal rights to medical treatment, informed consent, privacy protection, compensation for damages and medical supervision. This is not only the patient's legal right, but also his moral right.
2. Moral Obligations of Patients In medical activities, the moral obligations that patients should perform mainly include: ① the obligation to cooperate with doctors in diagnosis and treatment. (2) Abide by the rules and regulations of the hospital and respect the medical staff and their labor obligations. ③ Obligation to pay medical expenses. (4) the obligation to maintain and restore health.