①埃里克斯·默德(Alex Mold)有三篇代表性的文章涉及此主題,其研究時段集中在20世紀80年代之前:《重新定位病患:1960-1970年代英國病人組織、消費者保護主義和自治》(Repositioning the Patient:Patient Organizations,Consumerism,and Autonomy in Britain during the 1960s and 1970s[J].Bull,Hist.Med,2013,87)、《1960-1980年病人的權利和英國國民健康服務體系》(Patients Right and the National Health Service in Britain,1960s-1980s[J].American Journal of Public Health,November.2012,Vol.102,No.11)和《瑪格麗特·撒切爾英國時期病人—消費者的形成》(Making the Patient-Consumer in Margaret Thatcher's Britain[J].The Historical Journal,Vol.54,Issue 02,June 2011.);馬曉的《中英醫(yī)患關系道德調節(jié)的比較研究》(第四軍醫(yī)大學,2002年碩士論文);余成普的《國外醫(yī)患互動中的病人地位研究述評——病人角色理論到消費者權利保護主義》(《中國醫(yī)院管理》,2008年第1期);陳勇的《從病人話語到醫(yī)生話語——英國近代醫(yī)患關系的歷史考察》(《史學集刊》,2010年第6期)。
②“以病人為中心”(Patient-Centered)一詞是1956年由薩斯(Szasz)和郝雷德(Hollender)首次提出(Alan Bleakley,Patient-Centered Medicine in Transition-The Heart of the Matter,New York and London:Springer International Publish,2014),但并未得到醫(yī)學界的充分重視。80年代,“以病人為中心”的臨床方法作為一種概念首次應用于醫(yī)學研究和教學中,其包含五個層次的含義:一是了解病人關注和需要的信息;二是指把病患看成具有一定情感、思想的“人”;三是分析病人身體問題的共同根源與醫(yī)療管理方面的相互關系;四是改善預防和提高衛(wèi)生質量;五是指醫(yī)患之間建立長久的信任關系(Moira Stewart,ect,Patient-centered Medicine:Transforming the Clinical Method,Radcllife Medical Press,2003)。1983年,美國弗羅里達州的湖岸地區(qū)醫(yī)療中心首次將此概念付諸實踐。我國是在1996年11月的全國衛(wèi)生工作會議上,彭佩云提出把“以病人為中心”作為醫(yī)院的辦院宗旨。
③循證醫(yī)學又稱之為實證醫(yī)學,是一種新型的醫(yī)療范式,即在醫(yī)學文獻中需求最好的證據以應用于病人的醫(yī)護。它致力于給予每一個病人盡可能最好的醫(yī)療服務(Dan Mayer.Essential.Evidence-Based Medicine,Cambridge:Cambridge University Press.2004)。1992年,循證醫(yī)學一詞由喬丹·蓋亞特(Gordon Guyatt)提出,最初指一種新型的醫(yī)學教學方式。1996年戴維·L·斯卡特(David L.Sackett)及其同事明確界定其內涵,認為循證醫(yī)學指小心謹慎地、明確地、理性運用當前的證據以確定個體病人的治療方案,在醫(yī)療實踐中,主張綜合臨床醫(yī)生的經驗和醫(yī)學研究中病人最有效的外部臨床跡象以確定治療方案。(David L.Sackett,William M.C.Rosenberg.Evidence Based Medicine:What It Is And What It Isn't:It's About Integrating Individual Clinical Expertise And The Best External Evidence,British Medical Journal,Vol.312,No.7023(Jan.13,1996)。
原文參考文獻:
[1]Alex Mold.Repositioning the Patient:Patient Organizations,Consumerism,and Autonomy in Britain during the 1960s and 1970s[J].Bull,Hist.Med.2013,87.
[2]Donald Irvine.Doctor in the UK:their new professionalism and its regulatory framework[J].The Lancet.Nov.24,2001; 358.
[3]John Carrier and Ian Kendall.Health and the National Health Service[M].London:Routledge,2015.
[4]Connell,Jill; Bradley,Sue.Visiting children in hospital:A vision from the past[J].Paediatric Nursing.Apr 2000; Vol.12,No.3.
[5]Jonathan Hollowell(ed.).Britain since 1945[M].Oxford:Blackwell Publishing.2003.
[6]Tessa Richards.Interviews With Consultants[J].British Medical Journal.Vol.297,No.6640(Jul.2,1988).
[7]House of Commons Hansard.Mentally Handicapped Patients,HC Deb.23.January,1973.vol.849.[EB/OL].http://hansard.millbanksystems.com/written_answers/1973/jan/23/mentally-handicapped-patients.2015-11-6.
[8]House of Commons,Rights of Patients[Z].London:H.S.M.O.,April 10,1974.
[9]The Health Committee.Working for Patients[Z].London:H.S.M.O.,January,1989.
[10]Linda Beecham.Will It Be Better For Patients?[J].British Medical Journal,Vol.303,No.6805(Sep.28,1991).
[11]Dame Elizabeth Ackroyd.Rejection of Doctors as Moral Guides[J].Journal of Medical Ethics.Vol.10,No.3(Sep.,1984).
[12]John Warden.Letter From Westminster:Patients Rule OK?[J].British Medical Journal(Clinical Research Edition),Vol.294,No.6581(May 9,1987).
[13]John Warden.Letter From Westminster:Patient Power On The March[J].British Medical Journal(Clinical Research Edition),Vol.296,No.6635(May 28,1988).
[14]Stephen Bruster,Brian Jarman,Nick Bosanquet,Debra Weston,Robert Erens and Thomas L.Delbanco.National Survey of Hospital Patients[J].British Medical Journal.Vol.309,No.6968(Dec.10,1994).
[15]李本富,李曦.醫(yī)學倫理學十五講[M].北京:北京大學出版社,2007.
[16]Iain Dale edited.Labour Party General Election Manifestors 1900-1997[M].London:Routledge published,2000.
[17]The Health Committee.The NHS Plan:A Plan for Investment,A Plan for Reform[Z].London:The Stationery Office.July,2000.
[18]John Carvel.NHS constitution ends era of “doctor knows best”.Wednesday.21.January.2009.[EB/OL].http://www.theguardian.com/society/2009/jan/21/nhs-constitution-rights-treatment.2015-11-6.
(原文刊于《鄭州大學學報:哲學社會科學版》2016年第7期)