经济利益诱惑下医生尊重病人自主性的困惑探究

Fully exploring the issue of financial conflicts of interests between physicians and patients requires both survey conducting and normative pursuit. This paper first reports that only 15% of the physicians out of randomly-selected 45 hospitals would refuse prescribing a magnetic resonance imaging (MRI) scan for a patient who requests such a scan, although, it is not medically indicated or needed for the patient according to the physician’s professional judgment. Such diagnostic procedure can bring about financial benefit to the physician. How then should a physician act in these cases to manifest genuine respect for the patient’s autonomy? We discuss four different choices a physician faces and argue that in the Chinese familist medical cultural context, the physician should engage both with the patient and family in an adequate elaboration and manage to follow the final consensus of both the patient and family to fully respect the patient’s autonomy.