本文選題：健康觀　切入點：死亡觀　出處：《山西中醫(yī)學(xué)院》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：健康觀與死亡觀本質(zhì)上是人的一種價值觀,隨著實踐的深入而發(fā)展變化,同時又指導(dǎo)著實踐的方向與目的,兩者是相輔相成的關(guān)系。健康觀與死亡觀是醫(yī)學(xué)模式的基礎(chǔ)認(rèn)識,受到社會發(fā)展、科技進(jìn)步、醫(yī)學(xué)倫理、認(rèn)識水平、哲學(xué)觀念等綜合因素的影響,在指導(dǎo)人們的健康追求的過程中,又約束著醫(yī)學(xué)的進(jìn)步。健康觀隨著醫(yī)學(xué)模式的發(fā)展經(jīng)歷了四個階段,巫醫(yī)時代健康觀、自然哲學(xué)時代健康觀、生物醫(yī)學(xué)時代健康觀、生物-心理-社會醫(yī)學(xué)時代健康觀。死亡觀的發(fā)展變化主要在四方面:死亡標(biāo)準(zhǔn)、死亡方式、死亡態(tài)度、死亡處置。隨著生物-心理-社會醫(yī)學(xué)模式主導(dǎo)現(xiàn)代醫(yī)學(xué),形成了以生物、心理、社會三維一體的健康認(rèn)識,在多年來的醫(yī)療實踐中起了巨大作用。近年來生態(tài)危機的加劇給人類的生存與健康帶來了巨大威脅,同時醫(yī)學(xué)面臨的困境如耐藥菌的出現(xiàn)、慢性病與心理精神疾病的加速發(fā)展,生物-心理-社會醫(yī)學(xué)模式不能給予合理的認(rèn)識與有效的方法,倒逼著人類進(jìn)行醫(yī)學(xué)模式的反思。系統(tǒng)論科學(xué)、自然生態(tài)科學(xué)、可持續(xù)發(fā)展觀、微生態(tài)學(xué)、生態(tài)危機根源說等一些理論學(xué)說的產(chǎn)生與發(fā)展,《黃帝內(nèi)經(jīng)》生態(tài)學(xué)思想,為大生態(tài)醫(yī)學(xué)模式的提出奠定了基礎(chǔ)。死亡觀隨著社會文明、科學(xué)技術(shù)、醫(yī)學(xué)技術(shù)、哲學(xué)觀念、倫理道德的發(fā)展而變化。醫(yī)學(xué)、科學(xué)技術(shù)的發(fā)展,對部分心肺功能的停止通過搶救進(jìn)行逆轉(zhuǎn),這就對現(xiàn)有的死亡標(biāo)準(zhǔn)提出了挑戰(zhàn),因而腦干不可逆轉(zhuǎn)的功能消失被確立為新的死亡標(biāo)準(zhǔn)。安樂死的逐漸立法,臨終關(guān)懷學(xué)科的發(fā)展,反應(yīng)的是人們對死亡態(tài)度逐漸由恐懼、痛苦過渡到坦然、包容,死亡方式的選擇是一種價值觀的突破,是對死亡權(quán)利的要求。大生態(tài)醫(yī)學(xué)健康觀與死亡觀是在進(jìn)步理論、現(xiàn)實困境基礎(chǔ)上的創(chuàng)新。健康是人的身體和精神心理狀態(tài)與其生存環(huán)境的和諧適應(yīng)與良性互動。第一,人的健康必須放在大生態(tài)背景下考慮,因為大生態(tài)健康是人生存與健康的前提。第二,突破人類中心主義價值觀把倫理道德擴展應(yīng)用到人與生態(tài)環(huán)境的關(guān)系處理。大生態(tài)內(nèi)的生命與非生命都是道德主體,之間的關(guān)系是系統(tǒng)與系統(tǒng)的關(guān)系,并且人對生態(tài)負(fù)有責(zé)任與義務(wù)。第三,健康用程度衡量,并用動態(tài)的眼光認(rèn)識健康。一個人不能用健康與不健康籠統(tǒng)的判斷。健康不僅是當(dāng)下人的基本狀態(tài),更是自身狀態(tài)與周圍環(huán)境的不間斷的和諧適應(yīng)。死亡是個體人與社會關(guān)系不可逆轉(zhuǎn)的脫離和中斷。第一,首次包含了人的生物、社會雙重屬性。第二,從本質(zhì)上揭示死亡,具有哲學(xué)與現(xiàn)實雙重意義。第三,對醫(yī)學(xué)死亡標(biāo)準(zhǔn)的建立具有指導(dǎo)意義。健康死亡是指始終處于身心與生存環(huán)境和諧適應(yīng)狀態(tài)的人生實現(xiàn)生命的最后自然終結(jié),就像機器磨損到極限而自然損壞一樣。亦即《黃帝內(nèi)經(jīng)》中講的“形與神俱而盡終其天年,度百歲乃去”那種境界。健康死亡的提出,調(diào)整了醫(yī)學(xué)方向與目的。對于安樂死問題的解決提供了理論基礎(chǔ)與指導(dǎo)。國內(nèi)醫(yī)學(xué)生健康觀教育主要側(cè)重基礎(chǔ)的生物學(xué)認(rèn)識與臨床診療技術(shù),對心理精神健康、社會醫(yī)學(xué)、人文精神等方面教育缺乏。教育的功利性不利于生物-心理-社會醫(yī)學(xué)模式的實踐,導(dǎo)致多數(shù)醫(yī)生依然重技術(shù)而輕人文。國民的死亡觀受到傳統(tǒng)文化的影響較大,消極的重生避死認(rèn)識占主要。創(chuàng)新健康觀與死亡觀,有助于醫(yī)學(xué)生樹立健康生態(tài)觀、養(yǎng)成良好的健康習(xí)慣以導(dǎo)向社會人群、建立客觀理性地死亡觀有助于安樂死與臨終關(guān)懷學(xué)科發(fā)展、提高醫(yī)學(xué)人文素質(zhì)緩解國內(nèi)的緊張的醫(yī)患關(guān)系。
[Abstract]:The health view and the view of death is essentially a kind of people's values, with the deepening of the practice of development and change, but also guides the practice direction and purpose, the two are complementary relationship. Health cognition and basic concept of death is the medical model, by the development of society, the progress of science and technology, medical ethics, the level of understanding. The influence of philosophy concept of comprehensive factors, in the process of guiding people in the pursuit of health, and restrict the progress of medical health concept. With the development of medical model has experienced four stages, the witch doctor health concept era, healthy view of natural philosophy, health concept of biomedical technology, bio psycho social medical health concept. The development and change of concept of death mainly in four aspects: the standard of death, death, death attitude, death disposal. With the bio psycho social medical pattern of modern medicine, formed a biological, psychological, social three One dimensional health awareness, played a huge role in medical practice for many years. In recent years, the ecological crisis to human survival and health has brought a huge threat, while facing difficulties such as medicine of resistant bacteria, accelerate the development of chronic diseases and mental illness, bio psycho social medical model can not give a reasonable understanding and effective reflection method, forced down the medical mode of human beings. The system theory of science, natural science, the concept of sustainable development, microecology, the root of the ecological crisis that some of the emergence and development of the theory, "Huangdi Neijing > ecology thought, lays a foundation for the large ecological medicine with the view mode. The social civilization, science and technology, medical technology, philosophy of death, ethical development and changes. The development of science and technology, medicine, heart and lung function of part of the rescue into stop by For this reversal, the existing death challenges, and brainstem irreversible function disappeared was established as a new standard of death. Gradually the euthanasia legislation, the development of hospice care, the reaction is the people to death attitude gradually from fear, pain to calm, tolerance, death is a kind of choice the values of the breakthrough, is on the right to die. Ecological medicine health view and the view of death is in progress on the basis of theory, innovation dilemma. Health is harmonious to people's physical and mental state and their living environment and interaction. First, people's health must be placed on the ecological background to consider because of the large, ecosystem health is the prerequisite for human survival and health. Second, break through the anthropocentrism to ethics extended to deal with the relationship between the ecological environment and ecological life within. Life is a non moral subject, relationship between system and system, and who are responsible for the ecological health. Third, with a degree of measure, and use dynamic vision health. One cannot use healthy and unhealthy general judgment. Health is not only the basic state of contemporary people, is to adapt to their own state and the surrounding environment uninterrupted. Death is the harmonious relationship between individual people and society from irreversible and interrupt. First, for the first time including people's biological, social properties. Second, revealing death from the essence, philosophical and realistic significance. Third, has a guiding significance for the establishment of medical standard of death death is always in health. The physical and mental environment of living and harmonious adaptation life life finally achieve a natural ending, just like a machine worn to the limit and natural damage. That is the < Huang Di > About "the spirit and the body are all died of old age, is 100 degrees to that level. This health death, adjust the medical direction and purpose. To provide a theoretical foundation and guidance for solving the problem of euthanasia. The domestic medical students health education focuses mainly on the basis of biological recognition and clinical diagnosis and treatment technology of mental health, social medicine, lack of education of humanistic spirit and so on. The practice of education is not conducive to bio psycho social medical model, resulting in the majority of doctors still in technology and humanities. The national view of death is influenced by traditional culture, negative to avoid death rebirth. Knowledge occupies the main concept of health and innovation the concept of death, which is helpful for students to establish a healthy ecological outlook, develop good health habits to guide social groups, establish objective and rational view of death is helpful for euthanasia and hospice care development, improve The medical humanistic quality relieved the stressful doctor-patient relationship in China.

【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R-4;G641

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