Research on the Actual Conditions of the Role of Physicians and the Role of Patients in Contemporary USA under the Revolution of Medical Thoughts

医学思想在70年代美国社会发生了巨大的革命性变化。人们质疑医生专断的家长式权力，坚持医生的自主权，否定医生将病人作为操纵的对象。本研究的目的是分析当代美国医生角色和病人角色的实际状况，并弄清21世纪美国医生角色和病人角色的发展历程<st>。世纪。为此，我尝试在旧金山弗朗西斯科州立大学和洛杉矶加州大学医院进行参与式观察和对医务人员和病人的一些访谈，并分析我收集的大量研究报告材料。另外，笔者还尝试在伦敦大学和海德堡大学进行了一些研究，并与美国的情况进行了比较，结果表明， ...更多信息 在这些实地研究中，我可以证实以下几点。（1）与英国和德国相比，当代美国的医患角色发生了最大的变化。（2）这些变化是由指导思想而非法律引导的，与英国和德国的情况相反。(3)In美国知情同意制度化最严格并得到实际操作。（4）英国和德国的医生和病人的角色没有发生根本性的变化。（5）在美国的许多医院中，除了医生之外，还有许多其他职业，如生物伦理学家、医学社会学家、医学社会工作者、心理学家、神学家、律师。（6）团队医疗在美国比在英国和德国更制度化。（7）临终关怀在英国和德国比在美国制度化得更好。一般来说，我可以得出结论：“医学思想的革命在美国而不是在英国和德国走得更远。少

The Medical thought has received the great revolutionary change at the '70's of American society. People questioned the arbitrary paternalistic power of physicians and insisted the rights of self-determinations as well as repudiated doctors treat patients as the objects of manipulation. These situations I named 'the revolution of medical thoughts'.The aim of this research is to analyze the actual conditions on the role of physicians and the role of patients in the contemporary United States, and to make clear the course of these developments in the 21^<st>. century. For that sake I tried to do the participant observation and some interviews with medical people and patients at the Medical Hospital of San Francisco State University and Hospital of University of California at Los Angels as well as to analyze huge materials of study reports I have collected. Also I tried to do some researches in London University and Heidelberg University to compare with American situations.As the results … More of these field researches I could confirm the following points. (1)The roles of physicians and patients in contemporary America show the most drastic change comparing with England and German. (2)Furthermore these changes were led by Guideline, not Law, with contrast cases of England and German. (3)In the United States the informed consent is institutionalized most rigorously and is conducted actually. (4)The roles of physician and patients in England and Germany did not changed drastically. (5)Many such professions other than physicians as bioethicists, medical sociologists, medical social workers, psychologists, theologians, lawyer take part in many hospitals in the United States. (6)Team medicine is institutionalized in the United States more than in England and Germany. (7)Terminal cares are institutionalized very well in England and Germany than in the United States.In generally speaking I can conclude 'the revolution of medical thoughts goes far in the United States rather than England and Germany. Less