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01-09-2010 | Original Article

Serve the People: Understanding Ideology and Professional Ethics of Medicine in China

Author: Jingqing Yang

Published in: Health Care Analysis | Issue 3/2010

Abstract

The article explores the communist ideology that has guided the formation of professional ethics of medicine in China. It first explores the constitutions of the People’s Republic of China and the Chinese Communist Party and codes of practice for medicine enforced since 1949, showing that the core of the ideology in relation to health provision and doctor–patient relationship has always been ‘serving the people wholeheartedly’. The ideological undertaking, however, has never been successfully exercised. In the pre-reform era, the bureaucratisation of health professionals led to the emergence of ‘bureaucratic medicine’ featuring negligence of patients’ interests. In the reform era, the prevailing commercialisation of health care is in fundamental conflict with the ideological commitment to serving the people. As a result, the socialist professional ethics of medicine has not been satisfactorily practiced in reality.

‘Healing the wounded and rescuing the dying, and exercising revolutionary humanitarianism’ (jiu si fu shang, shixing geming de rendao zhuyi) was the words that Mao Zedong dedicated in 1941 to the first graduates of the Chinese University of Medical Science after it changed name from the Red Army Health School.

‘Three Represents’, first pronounced by Jiang Zemin in 2000, states that the CCP always ‘represents the development trends of advanced productive forces’; ‘represents the orientations of an advanced culture’; and ‘represents the fundamental interests of the overwhelming majority of the people of China’ (quoted from http://www.china.org.cn/english/zhuanti/3represents/68735.htm). This theory was included in the CCP Constitution and the PRC Constitution in 2002.

Anonymous. (1979a, 16 December). Ji jiji you wentuo, tuijin yiyuan jingji guanli (Actively and carefully pushing forward with hospital economic management). Jiankang bao (Health News), 2.

Anonymous. (1979b, 16 December). Kunming Yixueyuan Diyi Fushu Yiyuan jingji guanli huode chengxiao (No. 1 Affiliate hospital of kunming medical school obtained positive outcomes from economic management). Jiankang bao (Health News), 2.

Anson, O., & Sun, S. (2005). Health care in rural China—lessons from HeBei province. Hants, UK: Ashgate.

Bian, Z. (1981, 4 October). Bingren shang zhi ye qiu yi, qi jia yiyuan jie bu zhi (Patient with injured finger sought medical treatment at night, seven hospitals refused to treat). Jiankang bao (Health News), 1.

Bloom, G. (1998). Primary health care meets the market in China and Vietnam. Health Policy, 44, 233–252.CrossRefPubMed

Blumenthal, D., & Hsiao, W. (2005). Privatization and its discontents—the evolving Chinese health care system. The New England Journal of Medicine, 353(11), 1165–1170.CrossRefPubMed

Central Committee of the Chinese Communist Party, & State Council. (1997). Guanyu weisheng gaige yu fazhan de jueding (Resolution of health reform and development). Retrieved from http:///www.law-lib.com.

Chen, E. (1979, 21 October). Beijing shiji yiyuan weisheng jishu renyuan gongzi fuli qingkuang de diaocha (An investigation of the wages and benefits of health technicians in Beijing municipal hospitals). Jiankang bao (Health News), 1.

Chen, Q., & Liu, Y. (2003). Gongchandang yuan de dianfan: ji quanguo ‘kangfei’ youxiu dangyuan Liu Yingxia (The mdoel of communist party members: Liu Yingxia, the national party member of excellence of ‘Fighting SARS’) [electronic version]. Rednet. Retrieved from http://news.rednet.cn/c/2003/07/04/436004.htm.

10.

China Health Year Book Editorial Board. (2008). China health year book 2007. Beijing: Renmin Weisheng Chubanshe (People’s Health Press).

11.

Chongqing Municipal Health Department. (2003). Lizu gangwei, wusi fengxian, zuji ‘feidian’ (Hold on to the post, sacrifice selflessly, fight ‘SARS’) [electronic version]. Chongqing weisheng xinxi (Chongqing Health Bulletin). Retrieved from http://www.cqwsj.gov.cn/Html/2003-05/00002754.html.

12.

Cong, Z. (2004). Shengyang Zhongyiyuan ‘erci jixiao kaohe fenpei’ zhengduan diaocha (Investigation of ‘redistribution according to second performance assessment’ of Shenyang TCM Hospital). Huasheng chenbao (Huashang Morning Post). Retrieved July 17, 2007, from http://news.sina.com.cn/c/2004-06-07/01593389284.shtml.

13.

Cui, G. (1981, 18 October). Shang zhi yi hou… (After my finger was injured…). Jiankang bao (Health News), 1.

14.

Davis, D. S. (2000). Social class transformation in urban China: Training, hiring, promoting urban professionals, managers after 1949. Modern China, 26(3), 251–275.CrossRef

15.

Dictionary Compiling Office of the Institute of Language Studies of the Chinese Academy of Social Sciences (Ed.). (2002). The contemporary chinese dictionary (Chinese-English ed.). Beijing: Foreign Language Teaching and Research Press.

16.

Eggleston, K., & Yip, W. (2004). Hospital competition under regulated prices: Application to urban health sector reforms in China. International Journal of Health Care Finance and Economics, 4, 343–368.CrossRefPubMed

17.

Field, M. G. (1988). The position of the soviet physicians: The bureaucratic professional. The Milbank Quarterly, 66 (supplement 2: The changing character of the medical profession), 182–201.

18.

Field, M. G. (1991). The hybrid profession: Soviet medicine. In A. Jones (Ed.), Professions and the state: Expertise and autonomy in the soviet union and eastern Europe (pp. 43–62). Philadelphia: Temple University Press.

19.

Freidson, E. (1970). Profession of medicine: A study of the sociology of applied knowledge. Chicago and London: The University of Chicago Press.

20.

Gao, Q. (2005). Fanzhan yiliao weisheng shiye, wei goujian shehui zhuyi hexie shehui zuo gongxian (Develop medical and health enterprise, and contribute to the construction of a socialist harmonious society). Retrieved from http://www.moh.gov.cn/public/.

21.

Ge, Y., & Gong, S. (2007). Zhongguo yigai: Wenti, genyuan, chulu (Chinese health care reform: Problems, reasons and solutions). Beijing: Zhongguo Fazhan Chubanshe (China Development Publishing House).

22.

General Office of Guangdong Provincial CCP Committee (Ed.). (2003). Guangdong kang fei qun ying pu (Guangdong heroes of fighting SARS). Guangzhou: Nanfang Ribao She Chubanshe (South Daily Publishing House).

23.

Gong, X. (1981, 29 October). Legislation and supervision by the masses. Jiankang bao (Health News), 2.

24.

Gu, Y. (2007). Zhejiang dui 32 jia yiyuan diaocha biaoming, yiyuan shoushufei guodi yaojia taigao (Investigation of 32 hospitals in Zhejiang shows: Surgical fees are too low while drug prices are too high). Zhejiang zaixian (Zhejiang Online).

25.

Guo, S. (2000). Post-mao China: From totalitarianism to authoritarianism? Westport. Connecticut: Praeger Publishers.

26.

Health Department of the People’s Government of Northeast China (Ed.). (1951). Yiwu gongzuozhe de daolu—wesheng renyuan sixiang xuexi wenjian (Road for medical workers—ideological study document for health persennel). Shenyang: Dongbei Remin Zhengfu Weishengbu (Health Department of the People’s Government of Northeast China).

27.

Hsiao, W. C. L. (1995). The Chinese health care system: Lessons for other nations. Social Science and Medicine, 41(8), 1047–1055.CrossRefPubMed

28.

Ji, J. (2005). Zi pu yiyuan ‘kaidan ticheng’ jubao yisheng diu gongzuo (Doctors reporting ‘commission for prescription’ in their hospital were sacked). Beijing: Xinhua Net. Retrieved August 12, 2007, from http://www.hq.xinhuanet.com/news/2005-10/25/content_5423318.htm.

29.

Jiankang bao reporter. (1980, 16 June). Jingji guanli zhong de jige wenti (Problems caused by economic management). Jiankang bao (Health News), 2.

30.

Jiankang bao reporter. (1982, 30 May). Nei Monggu Zizhi Qu Weisheng Ting fachu tongbao: jiuzheng pianmian zhuiqiu shouru lanyong yaopin xianxiang (Inner mongolia autonomous region health department issued circular: Rectify the phenomenon of drug abuse driven by revenue-pursuing activities). Jiankang bao (Health News), 1.

31.

Li, S. (1979, 2 December). Yiyuan shixing jingji guanli shizai bixing (Implementation of economic management in hospitals is inevitable). Jiankang bao (Health News), 3.

32.

Li, L., & Li, H. (2000). Zhongguo de danwei zuzhi: Ziyuan, quanli he jiaohuan (Resources, power and exchange in the Chinese work uni organization). Hangzhou: Zhejiang Renmin Chubanshe (Zhejiang People’s Publishing House).

33.

Liang, Z. (1981, 29 October). Guanjian zaiyu kefu lingdao shang de huansan ruanruo zhuangtai (The key is to overcome the lax and weak leadership). Jiankang bao (Health News), 2.

34.

Liu, F. (1982, 6 June). Jilin Shi Disi Renmin Yiyuan jiaqiang yide jiaoyu, kefu enci guandian (Jilin no. 4 municipal hospital strengthened medical ethics education and overcame the view of bestowing). Jiankang bao (Health News), 1.

35.

Liu, W. (Ed.). (2003). Feichang zhanshi: Kang ‘feidian’ yi hu renyuan fangtan lu (Extraordinary fighters: Interviews with medical and caring personnel fighting ‘SARS’). Fuzhou: Fujian kexue jishu chubanshe (Fujian Science and Technology Publishing House).

36.

Liu, X., Liu, Y., & Chen, N. (2000). The Chinese experience of hospital price regulation. Health Policy and Planning, 15(2), 157–163.CrossRefPubMed

37.

Liu, G., Liu, X., & Meng, Q. (1994). Privatization of the medical market in socialist China: A historical approach. Health Policy, 27, 157–174.CrossRefPubMed

38.

Lu, J., & Fan, Y. (1981, 23 August). Shehui zhuyi yide hexin (The core of socialist medical ethics). Jiankang Bao (Health News), 3.

39.

Ma, B., et al. (1979, 21 October). Women zai shenghuo shang cunzai shiji kunnan (We have real difficulties in [daily] life). Jiankang bao (Health News), 1.

40.

Ministry of Finance. (1979). Guanyu wen jiao kexue weisheng shiye danwei, xingzheng jiguan ‘yusuan baogan’ shixing banfa (Provisional rules of ‘fixed budget’ for culture, science, health work-units and administrative work-units). Retrieved from http://www.law-lib.com.

41.

Ministry of Health (Ed.). (1958). Zonghe yiyuan gongzuo zhidu, zonghe yiyuan zongzuo renyuan zhize (Rules for general hospitals, and duties of staff of general hospitals). Beijing: Renmin Weisheng Chubanshe (People’s Health Publishing House).

42.

Ministry of Health. (1981a). Guanyu jiejue yiyuan kuiben wenti de baogao (Report on solutions for hospitals fuffering financial losses). Retrieved from http://211.144.101.75/yywsgl/yywsgl1/YYYLJGGL/XZFG/XZFG1003.htm.

43.

Ministry of Health. (1981b). Yiyuan jingji guanli zanxing banfa (Provisional rules for the administration of hospital economy). Retrieved from http://www.law-lib.com.

44.

Ministry of Health. (1985). Yiyuan gongzuo renyuan shouze (Rules for hospital workers). In Z. Wang & X. Li (Eds.), Shehui zhuyi yide (Medical ethics of socialism) (p. 399). Shenyang: Liaoning Keji Chubanshe.

45.

Ministry of Health. (1988). Yiwu renyuan yide guifan ji shishi banfa (Implementing measures and codes of medical practice for medical personnel). Retrieved from www.newhealth.com.cn/law/ws112.htm.

46.

Ministry of Health. (2003). Renshi Bu, Weisheng Bu, Jiefangjun Zong Zhengzhi Bu lianhe zhuishou Deng Lianxian, Ye Xing, Liang Shikui, Chen Hongguang, Li Xiaohong wu wei tongzhi “Bai Qiuen jiangzhang” (Ministry of personnel, Ministry of Health and the General Political Department of the People’s Liberation Army jointly confer posthumously the “Norman Bethune Medals” to Deng Lianxian, Ye Xing, Liang Shikui, Chen Hongguang and Li Xiaohong) [electronic version]. Weisheng renshi xinxi (Health Personnel Bulletin). Retrieved from http://www.moh.gov.cn/newsshtml/401.htm.

47.

Ministry of Health. (2007). Guanyu jianli yiwu renyuan yide kaoping zhidu de zhidao yijian (shixing) [The guidelines for establishing the medical professional ethics evaluation system for medical personnel (provisional)]. Retrieved from http://www.moh.gov.cn/newshtml/20868.htm.

48.

Ministry of Health, Ministry of Finance, Ministry of Personnel, State Price Bureau, & State Taxation Office. (1988). Guanyu kuoda yiliao fuwu youguan wenti de yijian (Suggestions on issues of expanding medical services). Retrieved from http://edu.xz.gov.cn/ws/flfg/030100121310.htm.

49.

Ministry of Health, & Ministry of Personnel. (2003). Guanyu shouyu Wei Jianing tongzhi “Bai Qiuen jiangzhang” de jueding (Resolution to confer “Norman Bethune Medal” to comrade Wei Jianing). Retrieved from http://www.satcm.gov.cn/lanmu/weishengbu/wjnbethune.htm.

50.

MOH Statistics and Information Centre (Ed.). (2004). Zhongguo weisheng fuwu diaocha yanjiu (Chinese health services investigation and study—an analysis report on the third national health services investigation). Beijing: Zhongguo Xiehe Yike Daxue Chubanshe (China Union Medical University Press).

51.

Qiu, X., Sun, F., & Wang, M. (Eds.). (2008). Yixue lunli xue (Medical ethics) (3rd ed.). Beijing: Renmin Weisheng Chubanshe (People’s Health Publishing House).

52.

Ryan, M. (1989). Doctors and the state in the soviet union. London: The MacMillan Press Ltd.

53.

Sidel, V. W., & Sidel, R. (1973). Serve the people: observations on medicine in the People’s Repbulic of China. New York: Josiah Macy, Jr. Foundation.

54.

Sidel, R., & Sidel, V. W. (1982). The health of China. Boston: Beacon Press.

55.

Sun, C. (2003, 20 December). Zhonggong Zhongyang Guowuyuan zhaokai quanguo rencai gongzuo huiyi, Hu Jintao Wenjia Bao Zeng Qinghong jianghua (The CCP central committee and the state council called the national conference of work on talented people, Hu Jintao, Wen Jiabao and Zeng Qinghong spoke). Retrieved from http://www1.peopledaily.com.cn/GB/shizheng/1024/2256582.html.

56.

Tang, X. (2004). Ta weihe likai zhe jia yiyuan? (Why he left this hospital?). Guangming ribao (Guangming Daily). Retrieved August 12, 2007, from http://www.gmw.cn/content/2004-12/16/content_149521.htm.

57.

Wilenski, P. (1976). The delivery of health services in the People’s Republic of China. Ottawa: International Development Research Centre.

58.

Wong, V. C. W., & Chiu, S. W. S. (1998). Health-care reforms in the People’s Republic of China. Journal of Management in Medicine, 12, 270–286.CrossRefPubMed

59.

World Bank. (1997). Financing health care: Issues and options for China. Washington, DC: The World Bank.

60.

Xie, Z. (2006). Hunan Changning Zhongyiyuan liu yisheng jukai huikou yao shouru jing bi menwei di (Six doctors from Hunan Changning TCM Hospital who refuse to prescribe drugs offering kickbacks receive incomes lower than gate keepers). Retrieved August 12, 2007, from http://news.xinhuanet.com/health/2006-07/26/content_4880333.htm.

61.

Xu, J. (1998). Dui wo guo weisheng jingji zhengce de lishi huigu (shang) (Historical review of our country’s health economic policies (1)). Guoji yiyao weisheng daobao (International Medical and Health Guiding News), 26, 44–47.

62.

Yang, J. (2006). The privatisation of professional knowledge in the public health care sector in China. Health Sociology Review, 15(1), 16–28.

63.

Yang, J. (2006). Wage reforms, fiscal policies and their impact on doctors’ clinical behaviour in China’s public health sector. Policy and Society, 25(1), 109–132.CrossRef

64.

Zhang, R. (1980, 15 October). Jianchi shixing zonghe kaohe jiangcheng banfa, Xi’an 11 suo yiyuan mianmao fasheng xiangzhu bianhua (Persistently enforcing comprehensive assessment and reward and penalty schemes, eleven hospitals in Xi’an changed significantly). Jiankang bao (Health News), 1.

Title: Serve the People: Understanding Ideology and Professional Ethics of Medicine in China
Author: Jingqing Yang
Publication date: 01-09-2010
Publisher: Springer US
Published in: Health Care Analysis / Issue 3/2010
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI: https://doi.org/10.1007/s10728-009-0127-y

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Serve the People: Understanding Ideology and Professional Ethics of Medicine in China

Abstract

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