【作者】 宋平；

【导师】 周燕；

【作者基本信息】 西南政法大学 ， 社会医学与卫生事业管理， 2017， 硕士

【副题名】以价值累加理论为视角

【摘要】 我国正处于社会结构转型时期,各类社会矛盾、社会纠纷、社会冲突频发,医患暴力冲突俨然成为其中的典型难题。近年来,我国医患矛盾不断激化,暴力程度愈演愈烈,致使医方问诊如履薄冰,患方就医将信将疑,动辄引发医患暴力冲突事件,医患关系发展到了历史冰点。屡禁不止的暴力伤医事件侵害了医患双方的生命安全和人格尊严,扰乱了正常的医疗秩序,严重影响了社会稳定,长此以往形成恶性循环,成为阻碍建设和谐社会的关键点,亟待社会各界合力解决。本文在具体分析一系列案例和数据的基础上,明晰我国医患暴力冲突的发展现状及特征,以价值累加理论为分析框架,对医患暴力冲突的成因进行系统分析,并提出相应的治理对策,为治理医患暴力冲突提供一种新的治理路径。价值累加理论系统解释了集体行为发生、发展的动态过程,认为集体行为的发生是多个因素共同作用的结果,即6个充分必要条件:社会结构性诱因;社会结构性原因滋生的不满、怨恨或剥夺感;一般化信念的产生;触发因素的引爆;有效的社会动员;社会控制失效。同样,医患暴力冲突的发生、发展也是各种因素相互作用的结果。本文作者认为:“以药养医”的机制弊端、“管办合一”的管理体制、医疗卫生资源投入失衡、医疗保险制度不完善等结构性原因;医患双方信息不对称、患方“相对剥夺感”放大导致的结构性紧张;患方急于强调自身权利、理性维权意识淡薄产生的普遍情绪;就医问诊环境欠佳、医患双方缺乏情感沟通、患者对治疗效果的不同认知等触发因素;舆论导向的负面失范效应、参与者非理性的行为模仿等行动动员;以及因缺乏对医患双方行为的法律约束、医患冲突纠纷解决机制不健全、防范预警机制欠缺而造成的社会控制失效,六方面原因综合作用导致了医患暴力冲突的发生。与此相对应,治理医患暴力冲突,重塑和谐医患关系,需要从破除结构性壁垒、消除结构性紧张、控制普遍情绪和行动动员、强化社会控制几个层面通盘考虑具体的治理对策。更多还原

【Abstract】 Our country is in the period of social structure transformation,all kinds of social conflicts,social disputes and social conflicts are frequent,violence has become one of the typical problems.In recent years,the contradiction between doctors and patients in our country is becoming more and more violent.The doctors handle cases with fear,and patients do not fully trust doctors,frequently lead to doctor-patient violence,the doctor-patient relationship has developed to the freezing point of history.Doctor-patient violence not only harm the life safety and personal dignity,but also seriously affected the normal medical order and social stability.If things go on like this will form a vicious spiral,becomes a key point to hinder the construction of harmonious society,which requires all sectors of society to work together.Based on the analysis of a series of cases and data,clear the status and characteristics of doctor-patient violence in Chinese,this paper makes a systematic analysis of the causes of the doctor-patient violence in the view of the value-added theory,and puts forward some corresponding countermeasures,which provides a new way for the governance path of the doctor-patient violence.The Value-added theory holds that the occurrence of collective behavior is the result of interaction of many factors,explains the collective action of a complete system of dynamic process.The value-added theory includes six necessary and sufficientconditions: structural conduciveness,structural strain,generalized beliefs,precipitation factors,mobilization for action,operation of social control.The occurrence and development of doctor-patient violence is the result of interaction of various factors.This paper indicates that the disadvantages of "medicine for the medical" mechanism and the management system of "who builds who manages" and imbalance of medical resources input,and the defects of medical insurance system lead to the structural incentives.Structural strain that produce because of the asymmetric information between doctors and patients,and "relative deprivation" increased.Such as anxious to emphasize patients rights and suffering from weak sense of rights and interests create generalized beliefs.Precipitation factors such as poor health care environment,and lack of emotional communication between doctors and patients,and different perceptions of patient outcomes cause the violence.Negative effects of public opinion guidance and participants’ irrational behavior imitation form a mobilization for action.And then operation of social control decreased because of the lack of legal constraints on the behavior of doctors and patients.And medical dispute resolution mechanism and early warning mechanism is not perfect.These six reasons lead to the doctor-patient violence.Corresponding to these reasons,in order to control the conflicts and build a harmonious relationship between doctors and patients,we must study on the specific measures to control the doctor-patient violence,such as getting rid of structural barriers and releasing structural strain,controlling generalized beliefs and mobilization for action,strengthening social control.更多还原