Research on ethical issues in diagnosis and treatment of colorectal cancer / 中国医学伦理学

Colorectal cancer(CRC)is one of the common malignant tumors,and its incidence rate and mortality rate in China are rising.As a high-incidence malignant tumor,in the process of screening,diagnosis,and treatment,CRC not only has universal ethical issues similar to other diseases,but also has its unique ethical problems,including the accessibility of CRC screening and medical insurance reimbursement,privacy exposure and the materialization of doctor-patient relationship during consultation and physical examination,the balance between"killing"and"nurturing"of cancer cells in excessive diagnosis and treatment,as well as the physiological and psychological issues of patients caused by enterostomy.This paper summarized and analyzed the special ethical issues in the diagnosis and treatment of CRC,and proposed corresponding countermeasures and suggestions.

Discussion on the Doctor-patient Relationship Model in Psychiatry Based on the Szasz & Hollender’s Model of Doctor-patient Relationship / 中国医学伦理学

Due to the particularity of mental diseases, doctor-patient relationship in psychiatric medicine is a subject that needs to be paid attention to. This paper focused on the discussion of the model of doctor-patient relationship in psychiatric medicine from the perspective of constructing a harmonious doctor-patient relationship. Based on the Szasz & Hollender’s Model of Doctor-patient Relationship and combined with the characteristics of psychiatric medicine, this paper discussed the applicable doctor-patient relationship models, namely, the shared participation model, the guidance-cooperation model, the active-passive model, and the protective-constraint model. The specific application of the shared participation model, the guidance-cooperation model, and the active-passive model in the psychiatric medicine context were introduced in detail, and the reasons and characteristics of the protective-constraint model added on the basis of Szasz & Hollender’s Model of Doctor-patient Relationship were elaborated. Meanwhile, the realization paths of the protective-constraint model in clinical practice were further explored, which included evaluating the behavioral capacity and consciousness state of patients with mental disorders, obtaining informed consent, and standardizing the use of intervention rights and withdrawal mechanisms. The discussion of this model will promote the improvement of doctor-patient relationship and the development of psychiatric medicine.

Major Health Economic Issues and Reform Orientation of Indonesia’s Health System / 中国卫生经济

Based on the health service delivery system and its performance, it shows the major issues faced by Indonesian health system, including heavy disease burden of NCD, imbalance allocation of medical care and resources, poor access to health service in rural area, low level of government health budget and so on. Presently, the reform in Indonesian health system is in the direction of equity and self-government, via participation of community, private sector or civil society, availability of comprehensive, equitable health care and health resource, to enhance health system and improve population health.