【摘要】 村卫生室实施基本药物制度的伦理困境主要表现为村卫生室"市场属性"与"公益属性"的经营角色、乡村医生"医务人员"与"农业劳动者"的职业角色、患者"完全理性人"与"有限理性人"的决策角色等定位混乱引发的利益冲突。要实现基本药物制度的顺利实施应遵循如下建议:制定明确的新医改政策伦理行为指引并以法律形式固化公益性判断标准;完善基本药物制度的顶层设计,提高"以人为本"的政策核心伦理;明确村卫生室及乡村医生的地位及角色,提高其伦理身份认同;合理运用解决患者伦理困境的政策宣传与健康干预工具,促进患者优先使用基本药物。更多还原

【Abstract】 The ethical dilemma of implementing the essential medicine system in village clinics was role conflict between"market property"and "public property"of village clinics,"medical personnel"and "agricultural laborers’ "of rural doctors,"completely rational person"and"the limited rationality of people"of patients.In order to implement the essential medicine system,it is suggested to clarify new medical reform policy and laws for guiding ethical behavior,perfect the top-level design of essential medicine system,improve the "people-oriented"core ethics,identify the role of village clinics and rural doctors,and rational use policy propaganda and health intervention tools.更多还原