文 / 周亦川 编 / 袁月

【搜狐健康】日前，《柳叶刀》官网发布评论《保护中国医生》（Protecting Chinese doctors）指出，解决暴力侵害医护人员问题不能仅靠惩罚措施，更要提高整个社会对卫生行业工作者的信任和尊重。

评论指出，2019年12月24日，北京民航总医院急诊医生杨文被一名患者的儿子刺死，致使中国的医患关系触底。这起谋杀事件受到了中国医师协会的谴责并引发了公众的愤怒。同年12月28日，中国最高立法机关批准了第一部保护医护人员的基本法，将于2020年6月1日生效。法律禁止任何组织或个人威胁和损害医护人员的人身安全或尊严。

这一做法值得称赞，但仅靠法律手段不太可能充分解决这一复杂的问题。

评论指出，暴力侵害卫生专业人员是一个全球性的问题，影响到几乎所有卫生保健机构的医护人员。然而在中国，袭击医护人员的规模、频率和恶性程度尤其严重。暴力侵害医护人员的原因很多，包括初级卫生保健体系不完善，医患沟通不畅，等等。仅通过加强安全措施解决日益恶化的局势，收效甚微。

为此，《柳叶刀》在长期以来支持中国医护人员和卫生保健系统改革的基础上，将于2020年与中国展开进一步合作。杂志将推出一篇关于提高中国初级卫生保健质量的评论文章；颁发“威克利-伍连德奖”，让中国医生分享他们的医患故事；推出一个以中国为主题的专题，展示关于改善中国临床实践和卫生政策的高质量研究成果。

该评论在总结中指出，仅通过执法和惩罚措施无法制止发生在中国的针对医护人员的暴力行为，更多的需要文化上的转变，这是一项时间工程。医护人员需要得到信任和尊重，而增强这种信任和尊重的最好的方法，就是建立一个有效、可信、收到尊重的卫生系统。

原文如下：

The doctor–patient relationship in China seemed to hit rock bottom when Wen Yang—an emergency physician in Beijing Civil Aviation General Hospital—was fatally stabbed by a patient's son on Dec 24. The killing was condemned by the Chinese Medical Doctor Association and triggered an outpouring of anger among the public. On Dec 28, China's top legislator approved the first fundamental and comprehensive law for protecting health workers, which will take effect on June 1 this year. The law bans any organisation or individual from threatening or harming the personal safety or dignity of health workers. Although laudable, a legal approach alone is unlikely to address adequately this complex problem.

Violence against health professionals is a global concern and affects health workers in nearly all health-care settings. However, the scale, frequency, and viciousness of attacks on medical workers in China are particularly severe. Reasons for violence against health workers in China are many, including an inadequate primary health-care system and poor doctor–patient communication. Attemps to fix a deteriorating situation, such as increased security measures, have had little impact.

The Lancet has long supported Chinese health workers and health-care system reform, and we plan to work with Chinese partners further in 2020. Highlights will include a review on improving the quality of primary health-care in China, the second Wakley-Wu Lien Teh prize, which will give a voice to Chinese physicians to share their stories, and a China-themed issue to showcase high quality research to improve clinical practice and health polices in the country. Violence against health workers in China will not be halted through law enforcement and punitive measures alone; a cultural shift is required, and this will take time. Health-care professionals need to be trusted and respected. The best way to enchance trust is to create an effective health system that is credible and respected also.

参考资料：

1. thelancet

Protecting Chinese doctors

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30003-9/fulltext