社会冲突理论视角下的医疗纠纷解决方式_英文_
现代生物医学进展https://www.sodocs.net/doc/ce1792155.html, Progress in Modern Biomedicine Vol.11NO.13JUL.2011
·医疗纠纷与防范·
Medical Dispute Solution in the Perspective of Social Conflict Theory
NIU Yong-zhu 1,MIAO Zhi-min 2
(1Qingdao University Medical College,Qingdao,Shandong,266021,China;
2The Affiliated Hospital of Medical College Qingdao University,Qingdao,Shandong,266003,China )
ABSTRACT:Along with social economy development and people living standard enhancement,people's healthy demand index is getting higher and legal consciousness is getting stronger as well.At the same time,the medical dispute cases related to malpractice are increasing year by year.The effective solution on medical service dispute will be helpful to establish the harmonious relation between health workers and patients.The harmonious relation is a main constituent in the process to develop harmonious society.In the perspective of sociology,Social conflict theory from Dahrendorf and Lewis Coser are applied to analyze the causes and development of the medical dispute and the measurements are also proposed.
Key words:Medical dispute;Social conflict;Relation between health doctor and patient Chinese Library Classification(CLC):R197.32Document code:A Article ID:1673-6273（2011）
13-2555-03Author:NiuYong-zhu(1984-),Male,Research Direction:Hospital Management,Tel:150********,E-mail:niu_yong_zhu@https://www.sodocs.net/doc/ce1792155.html, (Received:2010-11-30Accepted:2010-12-27)
Introduction
With the depth reform and development of market economy,people's self-protection awareness and expectation of health care are rising in recent years.The medical dispute not only become a trouble in the hospital work but also is a focus of social concern a -nd difficulties of hospital management.Generally believed that medical dispute cases reflect detrimental relationships between he-alth-care professionals and care recipients (or families),the medic-al dispute cases related to malpractice are increasing year by year,and become the hot topic in public.The effective solution on med-ical service dispute will be helpful to establish the harmonious rel-ation between health workers and patients.The harmonious relatio-n is a main constituent in the process to develop harmonious socie-ty.This article will be in the perspective of the social conflict theo-ry from Dahrendorf and Lewis Coser to analyze the causes and de-velopment of the medical dispute.
1Social conflict theory
1.1Dialectical conflict theory
[1]
Dahrendorf [2]
held that conflic is inescapable,which is a perv-asive aspect of existence.The social conflict model is created by the theory of structure and function,all units of social organization are in the progress of continue change,and wherever there is a conflict in social life.Conflict is the driving force for social chang-e,so it is a abnormal phenomenon that there is no conflict and ch-ange in the social life.The unequal distribution of power will lead to social conflict.Power and authority are scarce resources in the social life.So there are some differences between power and auth -ority in social organization.Yet these differences in the allocation of resources change into the determinants of social conflict.That it
results in the struggle and competition in the various groups,which is the root cause of conflict and change.
Dahrendorf also considered that the interests between quasi-group and significant group will lead to the social conflict.Two groups respectively stand for two different interests.When conditi-ons are ripe,the obvious interest will turn into potential interest.T-he formation of groups is based on the groups which stand for obv-ious interest.When the social conflict is formed,it is no vain to try one ’s best to suppress and eliminate the conflict by some ways.Social conflict should be adjusted by some institutions .There are three mediation methods to the social conflict:first,it can be medi-ated by social public institutions with the way of consultation;sec-ond,the third party which is out of the conflict propose the method of resolving the conflict;third,two parties can mediate the conflict by the arbitration institutions.1.2Social safety valve theory [1]
Lewis Coser believed that all the components and departme-nts in the social system are associated with each other.When the social system beg an to work,the incompatibility will be arise,which is attributed to the differences between the operation modes.So it is a phenomenon that the disorder and conflict of interest will be take place in the social.Lewis Coser also considered that the social conflict play an extent role in the process of the social reorg-anization.The social system must take some institutions in order that people can excrete the hostile and aggressive feelings.That is the social safety valve system.
2The medical dispute in the perspective of
social conflict theory
2.1The perspective of dialectical conflict theory
From the perspective of dialectical conflict theory,medical d-
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现代生物医学进展https://www.sodocs.net/doc/ce1792155.html, Progress in Modern Biomedicine Vol.11NO.13JUL.2011
ispute have positive and negative effects.That is both constructive and destructive.When medical dispute occurs,doctor and patient will take it a lesson.It will make them try their best to find better treatment programs.After that the relationship between doctor and patient will become much more harmonious.Unequal distribution of power will give rise to social conflict.Power and authority are scarce resources in the social life,but they have significant differe-nces.So these differences make people have different social status and social roles.
As long as the people are ill,they will go to hospital.So pati-ents must take the doctor's advices,which include the treatment programs and so on.Seeing from the asymmetric information theo-ry,because the difference of medical knowledge and interest betw-een doctor and patient,their awareness and motivational are respe-ctively different when there is a dispute treatment in the hospital[3].
Suffering from the weak side because of some factors,the pa-tients have no choice but attached to the medical side.So the patie-nt is dominated by the doctor.The doctor has a decisive role in the progress of diagnosis and treatment,while the relationship betwee-n doctor and patient is dominated by their unequal right when they are driven by economic interests.As a result,there are some unde-sirable phenomenons in the hospital,which do serious damage to the interests of patients.Thereby the high medical authority of do-ctors is one of the causes of medical dispute.
2.2The perspective of social safety valve theory
The patients go to hospital in order to relieve the pain of dise-ase,and they have a great hope to the medical practice of hospital. Once the effects of treatment fall short of their demands,the patie-nts and their families will be resent and hostile.Although the heal-th care system is improved,there are heavy financial burdens on patients.The hospital is in the pursuit of economic interests,which increased the hostility of patients.Yet the hostility must be excret-ed by some way.So the hospital must take proper measures to exc-rete the patients’hostility.
3The solution of medical dispute
According to the social conflict theory,since the root causes of social conflict can not be completely eliminated,but also towar-d the goal of harmonious development,so the best way to solve m-edical dispute is to come up with ADR for medical dispute.Alter-native dispute resolution(ADR)is a term that encompasses a broad range of problem-solving methods,including consulting、mediatio-n and arbitration mechanism.
3.1Consulting mechanism
Consulting mechanism,the most frequently used method of ADR,is defined as the process whereby two or more disputing parties confer together in good faith so as to settle a matter of mut-ual concern[4].The approach to negotiation may be positional or pr-incipled.In positional negotiation,divergent parties incrementally concede their position until a compromise is reached.In principled negotiation,the parties generate options focused on their interests to arrive at an agreement based on objective criteria.Negotiation serves as the basis for mediation;an important ADR method used in medical disputes[4].The disputing parties can settle their differen-ces themselves or ask a lawyer or other representative to handle the consultation.Consulting works best when one party is not in a position of control and when both parties are willing to talk and to compromise.The mutually agreed on result is likely to best meet everyone's needs.
3.2Mediation mechanism
In a mediation situation,a neutral and impartial third party trained in mediation skills will help the disputing parties negotiate and arrive at a mutually agreeable resolution.The mediator acts by identifying issues,proposing solutions,and encouraging accomm-odation on both sides[5].This is done in an informal setting and fol-lows no formal rules.The mediator does not decide the outcome that is decided by the disputing parties but assists in facilitating communication between the parties.The mediator helps the parties clarify issues,identify their interests,and create options that meet their needs.When both parties agree on a solution,the parties,the mediator,or a lawyer may put the agreement in writing.If the part-ies are unable to reach a mutually satisfactory solution through mediation,they can take their dispute to court.
3.3Arbitration mechanism
Arbitration often is used in situations that require an impartial third person to decide a dispute for the parties quickly and conclu-sively.Some arbitrators specialize in specific,complicated issues. In an arbitration,the parties present testimony or supporting docu-ments,and they may use attorneys if they wish.The parties must agree beforehand to abide by what the arbitrators decide.There is only a limited right to court review of an arbitrator’s decision,wh-ich can be enforced by either party in court.So arbitration can be private,arising from the terms of a contract between the parties,or judicially mandated by statute or rule[4].Potential advantages of ar-bitration over judicial trials for resolving malpractice claims are: speed,simpler and less expensive proceedings and privacy.
4Conclusion
In summary,harmony is the theme we advocate in today's so-ciety,people are the subject of a harmonious society,so harmonio-us relations between doctor and patient play an important role in the processes of building a harmonious society.However,due to the asymmetry of information between doctors and patients,the in-cidence of medical disputes is inevitable.Only by establishing ef-fective settlement mechanisms,medical dispute could be settled justly and scientifically.Medical industry now is considering ADR as a possible problem-solving forum[6].So it is necessary to add A-DR into medical dispute settlement mechanism.To set up a multi-ple settlement mechanism shall wipe off the conflict between med-ical institution and patients and maintain a harmonious society.
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现代生物医学进展https://www.sodocs.net/doc/ce1792155.html, Progress in Modern Biomedicine Vol.11NO.13JUL.2011
社会冲突理论视角下的医疗纠纷解决方式
牛永祝1苗志敏2
(1青岛大学医学院山东青岛266021；2青岛大学医学院附属医院山东青岛266003)
摘要：随着社会经济的发展和人们生活水平的提高，人们的健康需求指数越来越高，法律意识也越来越强。与此同时，由医疗事故等原因导致的医疗纠纷案件正呈逐年上升趋势。有效地解决医疗纠纷，有助于建立和谐的医患关系，而和谐的医患关系是构建和谐社会一个主要的组成部分。本文在社会学视角下，运用达伦多夫和科塞的社会冲突理论来分析当前的医疗纠纷，从而促进医疗纠纷的解决。
关键词：医疗纠纷；社会冲突；医患关系
中图分类号：R197.32文献标识码：A 文章编号：1673-6273（2011）
13-2555-03作者简介：牛永祝（1984-），男，硕士研究生，研究方向：医院管理，电话：
150********，E-mail:niu_yong_zhu@https://www.sodocs.net/doc/ce1792155.html, （收稿日期:2010-11-30接受日期:2010-12-27)
References
[1]Hou Jun-sheng.Western sociology tutorial [M].Tianjin:Nankai Univ-ersity Press.2006.265-279
[2]Dahrendorf R.Toward a theory of social conflict [J].Conflict Resolut-e,1957,2(2):170-183
[3]Li Hong-Xia.The asymmetric information study in the medical service
[J].Medicine and Philosophy,2006,26(7):47
[4]Brearton JJ,Hinck KE,Lott E,et al.Alternative dispute resolution in
American Jurisprudence,IV [M].2nd edtion.Rochester,NY:Lawyers Cooperative Publishing.1995:7-23
[5]Fraser JJ.Medical malpractice arbitration:a primer for Texas physici-ans [J].Tex Med,1997,93(1):76-80
[6]Robin Song.Effective doctor-patient communication:building bridges
and bridging barriers [J].Can J Neurol Sci,2002,29(2):188-189
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