On the Sociality of Medicine
Keywords medicine
Medicine is a natural science, its carrier is human life, and its purpose is infinitely close to the truth of human life process. Medicine should meet the medical needs of society and realize its function of safeguarding human life in society, so medicine is social. The sociality of medicine is reflected in the fact that the development of medicine cannot be separated from the development of human society, and it is also reflected in medical social work.
1 The development of medicine is closely related to the development of human society.
Medicine is "a scientific system for studying human life process and preventing and treating diseases". Medicine is a natural science, but it also adheres to the principles of objectivity, testability, verifiability and repeatability [1]; The research object of medicine is essentially the process of human life; Doctors rely on their own knowledge and experience to protect people's health and eliminate their suffering. The basis of a doctor's work is medical science and technology, but because he works with people, medicine is not simply science and technology, but a high combination of high technology and humanities.
1. 1 The development of medicine is closely related to the development of social economy (1). In ancient times, doctors in China were specialized professions. For example, in Zhou Li Tianguan has official documents about doctors' duties. However, due to the relatively backward economic conditions at that time, not every doctor received strict professional training. Generally, people with a little knowledge and mastery of medical affairs can prescribe drugs, and there are still traces to follow until now. (2) Since the Qin and Han Dynasties, internal and external communications have become increasingly developed, and rhinoceros horn, amber, antelope horn, musk, longan and litchi seed in the South China Sea have been gradually adopted by mainland doctors. Medicinal materials from Southeast Asia and other places have also continuously entered China, enriching people's understanding of medicinal materials. Shennong Ben Cao Jing is the earliest existing pharmacological monograph in China. It summarizes people's understanding of drugs before the Han Dynasty, includes 365 kinds of drugs, and describes pharmaceutical theories such as monarch, minister, assistant, envoy, harmony of seven emotions, four qi and five flavors. There is also a masterpiece handed down from ancient times, namely Huangdi Neijing. Her scientific exposition is extensive and profound, involving not only medicine, but also various scientific achievements made by mankind such as astronomy, geography, philosophy, anthropology, sociology, military science, mathematics and ecology. (3) During the Sui and Tang Dynasties, due to political unity, economic and cultural prosperity, developed internal and external transportation, more foreign drugs and more experience in drug use, it became an objective need to further summarize the achievements in pharmacology at that time. In 657 AD, the Tang government organized more than 20 people, including Su Jing, to compile Compendium of Materia Medica, which was completed in 659 AD and was also the earliest national pharmacopoeia in the world. It was 883 years earlier than the Nuremberg Pharmacopoeia issued by the European Nuremberg government in A.D. 1542. The book has 54 volumes, including three parts: materia medica, drug map and classics, and contains 850 kinds of drugs, which has a great influence abroad. (4) During the Jin and Yuan Dynasties, many distinctive medical schools appeared in China. Li Shizhen, a medical scientist in the Ming Dynasty, wrote Compendium of Materia Medica, which contains 1892 kinds of drugs and 10000 prescriptions, making outstanding contributions to the development of pharmacology in China and the world. Around 1 1 century, Chinese medicine began to use "human pox vaccine" to prevent smallpox and became a pioneer in medical immunology in the world. Since modern times, due to the economic development of China, Chinese medicine has made good achievements in all aspects. The victory against SARS in 2003 is the best example.
1.2 The development of medicine has a positive educational effect on human beings (1). Ancient medicine in China developed earlier, which was closely related to traditional Confucianism. Many medical masters in the past dynasties entered medicine from Confucianism, and the idea of actively using the world was more prominent. The core issues of Confucianism, "benevolence" and "courtesy", are also the thoughts guiding medical practice. In the preface of Fang, Sun Simiao clearly pointed out that "great doctors treat diseases ... first show great compassion and swear that general education includes mental pain." In the words of Yuan Mei who commented on Xue Xue's medical practice in Qing Dynasty, "A sage is heartless, and a gentleman can use his skills to make his people feel disrespectful, which is also the learning of Confucius." The idea of "benevolence" runs through from Zhou Li Medical Chapter to The Complete Collection of Ancient and Modern Books by the Ministry of Medicine. It can be said that the history of traditional Chinese medicine is a history of humanism with dazzling light. In the market economy society, many people try their best to grab wealth, trample on human nature and destroy human relations. Even in the medical field, cheating is not uncommon regardless of people's lives and taking advantage of people's dangers. Taking the history of Chinese medicine as a clear reference in today's medical field and as a great help for today's mercenary, the positive significance is obvious [2]. (2) China ancient medical great man. He often engages in medical activities with a rigorous scientific attitude in the spirit of seeking truth from facts and being brave in exploration. Therefore, they played an exemplary role at that time and even later generations. From Zhang Ji to the later four masters in Jin and Yuan Dynasties, they were all famous for their febrile diseases. They all remembered their predecessors scientifically, critically absorbed their experience, boldly put forward their own opinions and founded their own theories, which promoted the continuous development of China's medical career and thus promoted the progress of mankind.
Different social times have different medical models.
Medical model is a standard form and method for human beings to observe, analyze and deal with various problems in the struggle to protect health and diseases at different historical stages and scientific development levels. There are many medical models in history. (1) During the Western Zhou Dynasty, a whole set of medical administrative organizations and medical examination systems were established: decrees on placing doctors and taking charge of them; It is also divided into disease doctors, selective doctors, food doctors and veterinarians, which is the beginning of medical division. At that time, government agencies had set up officials to store ice and turn it into fire to save time. In the 5th century BC, the medical scientist Qin Yueren (Bian Que) used diagnostic methods such as observation, questioning, smelling and feeling, especially pulse diagnosis. (2) Now we are facing the transformation from biomedical model to bio-psychological-social medical model [3]. The understanding of human attributes in biological, psychological and social medical models includes human biological attributes and social attributes, and discusses the occurrence and change of diseases from biological level to social level. The medical model adds psychological and social factors. Under the old model, psycho-social factors will not be invalid because they are not recognized, nor will they replace biological factors because they are recognized. Psychosocial factors have become the content of medical model because of their influence on biological factors, but the carrier of medicine is still human life, and the essence of medical research is still the process of human life. Therefore, the new medical model does not make medicine go beyond the scope of natural science, but become an interdisciplinary science between natural science and social science-social medicine in essence [4]. The bio-psychological-social medical model not only attaches importance to biological factors, but also attaches importance to the influence of social and psychological factors on diseases and health, and even forms a series of emerging disciplines such as social medicine, psychosomatic medicine and clinical psychology. It holds that the maintenance of human health depends on medical technology, ecological environment, cultural psychology, lifestyle, health care policy, economic development and other factors, and also plays a decisive role to a certain extent. This medical model not only made these understandings of health and life conceptually, but also began to demonstrate from the medical point of view, such as the pain tolerance of people with different cultural psychology, the influence of psychological factors on diabetes treatment, the influence of doctor-patient relationship on the rehabilitation of elderly patients, and the influence of serious natural disasters on children's mental health. These studies have proved in practice that this medical concept meets the needs of human health maintenance. Because of this, it has realized the organic unity of reductionism and holism, medical technicalism and humanism in the medical field [5].
3 medical sociality requirements for medical staff
Today, medical social workers have traveled to hospitals and communities in many countries around the world. The task of medical social workers is to pay attention to patients' social attributes, grasp patients' social psychological factors, share social work outside medical technology, expand social psychological adjustment work that is beneficial to patients and their families to cope with diseases and deaths, improve patients' adaptability, mobilize patients' internal self-healing ability, find another way outside medical technology, and promote patients' recovery as soon as possible; The purpose is to strengthen the humanistic care and care of medical services; Work hard with medical staff to achieve the "whole person" service goal of medical care. At present, efforts should be made to resolve the contradiction between doctors and patients and reduce medical disputes. Through medical social work, we can improve patients' satisfaction, establish a good hospital image, improve hospital reputation, enhance hospital competitiveness, and finally promote social civilization and progress. (1) Medicine serves the society, and medicine alone is not enough. Properly speaking, the social realization of medicine is a social science, even a large-scale political science. It is impossible for doctors to carry out research on health service institutions, health economics, technology and standard evaluation, decision analysis and so on in the process of drug use. This requires the participation of statisticians, economists and sociologists. Medicine must work with sociology, economics and statistics to realize the mission entrusted by society. Based on this, medicine should go beyond narrow vision and be closely integrated with sociology, economics and statistics in social practice; On the other hand, the promotion of medicine can not only focus on medicine in social practice. The society also needs to have a strategic vision and actively use economic and social means to promote the public health system based on medicine to play its due role in society. The social practice of medicine cannot only stay in medicine, nor can it rely on medicine in isolation. We should make full use of drugs and not expand the scope of drugs. (2) Medical social work focuses on patients' social attributes, makes up for the deficiency of pure biomedicine, strengthens humanistic care, and realizes the perfection of health service mode. So many people have close cooperation with medical staff and need to coordinate with other departments of the hospital [6]. For example, patients have questions and opinions about diagnosis and treatment, and we can give correct explanations according to our own knowledge background, but some problems must be clearly explained by medical staff to patients and their families. In particular, the current medical social work should assist the communication and understanding between doctors and patients, understand the hopes, demands and opinions of patients and their families, and feed them back to hospital managers and medical staff in time to improve the work of hospitals. (3) Social work has an internationally recognized meaning, that is, helping others with altruistic values. Although the specific professional fields of social work are different, social work should fully consider the needs of recipients and their subjectivity, and humanitarianism is the most basic professional ethics principle [7]. Maintaining life and caring for health are the first value principles of medical social work. Medical social workers must respect and care for patients, and everything starts from the health interests of patients. Enthusiasm, understanding and sincerity are the basic qualities that should be possessed. Medical social workers are professionally trained and have certain professional skills. They should use scientific help skills as a means to realize the effectiveness of help activities. They should provide safe, effective and constructive social services to the society with extensive knowledge, skills and values. China can't be too demanding now, but some training is necessary [8]. Value theory is the soul of social work, and the training of values and ethics is essential; Relevant theories of sociology and psychology are the foundation. It is also important to study and discuss social work methods and skills; The possession of medical health knowledge is conducive to the professional needs of medical social work [9].
Medicine is not only a natural science, but also a social science. The medical social work we have done is still a preliminary exploration, and we need to continue our efforts. We believe that with the social transformation, the development of medicine and the change of health concept, the medical social work with China characteristics will certainly develop and mature.
refer to
1 Cai, Hu Huaiming, Hou. Preliminary study on bio-psychological-social-ecological medical model. Journal of Mudanjiang Medical College, 2004, 5:23-242.
2 Liang Caigao. Historical mission of social medicine. Medicine and society, 1998, 1 1 (2): 1-3.
3 yuan. On the clinical application of bio-psychological-social medical model, Journal of Hubei University for Nationalities (Philosophy and Social Sciences Edition), 2004, 1: 5-6.
4 Hongman, Huiman. Humanistic medicine in the new century. Medicine and society, 1999, 12 (6): 18-20.
5 Guo. Need to update the medical model again. Health news, 2003-11-15.
6 Qin Huiji. Medical model. Journal of Biology, April 22, 2004.
7 Zhang Jinzhong. The moral connotation of evidence-based medicine is taken from. Journal of Medicine and Philosophy, 2003, 4: 28-29.
8 Chen Bangxian. History of Chinese medicine. Shanghai: Shanghai Bookstore, 1984, 106-358.
9 Wu Mingtuo. Calling for medical legislation to correctly adjust the relationship between doctors and patients. China Medical Information Herald, 2002, 17 (24): 13.
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