不同主体视角下医疗纠纷的成因及其解决策略研究

摘要

不同主体视角下的医疗纠纷成因及其解决策略既有相同点，也有不同之处：患方认为，医方片面追求经济利益、缺乏责任心、倚强凌弱和医院就医环境差是导致医疗纠纷的原因，对此应从切实履行政府职责、遏制医疗费用的不合理上涨、严格医院管理和充分保障患方利益等方面加以解决；医方认为，医学领域存在不可避免的风险、医师超负荷工作、部分医师责任心缺失、医院各部门间配合不够和患方认知错误是导致医疗纠纷的原因，对此应从严格实施分级医疗制度、建立医疗纠纷应对机制和建立医疗责任赔偿分担机制等方面加以解决；纠纷解决第三方认为，医疗资源配置有问题、医方的错误和患方的误解以及缺乏顺畅的医疗纠纷解决渠道是导致医疗纠纷的原因，对此应从建立缓冲带、严惩闹事者和完善第三方调解机制等方面加以解决；政府认为，政策导向错误、管办一体的体制具有先天缺陷和未实施分级医疗制度是导致医疗纠纷的原因，对此应从完善政府治理、建立医疗领域的信任、创建同业平等竞争相互监督的新机制和构建深度覆盖的医疗救助体系等方面加以解决。%There are some similarities and differences in the causes and strategies for medical disputes under the perspective of different main body. The patients argued the causes for medical disputes are as follows: the hospitals' one-sided pursuit of economic interests, lack of responsibility, the reliance on the strong and the bully-ing of the weak, and poor hospital environment, which should be solved by implementing the government respon-sibilities effectively, curbing the unreasonable rise in medical costs, strictly managing the hospital, and fully guar-anteeing the hospitals' interests. The hospitals thought the causes for medical disputes are the unavoidable risks in medical field, physicians' overload working, some physicians' lack of responsibility, insufficient cooperation among departments in hospitals, and the patients' cognitive errors, which should be solved by strictly implementing hier-archical medical system, establishing medical disputes coping mechanism, and establishing medical liability com-pensation sharing mechanism. The third party of dispute resolution argued that the causes for medical disputes are something wrong with the medical resource allocation, the doctors' errors , the patients' misunderstandings, and lack of the smooth channel for medical dispute resolution, which should be solved by establishing a buffer, severely punishing rioters, and perfecting the third party mediation mechanism. The government argued that the causes for medical disputes are policy guidance errors, birth defects in management integrated system, and the ungraded medical system, which should be solved by perfecting the governance, fostering trust in the medical field, creating a new mechanism of mutual supervision and trade fair competition, and building deep-covered medical assistance system.