Structural Dilemma in Health System Reform in the Chinese Mainland and Emerging of Structure-Based Bioethics Paradigm

Copyright © 2013 Liu Jitong, Zhang Dongqi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. After reviewing the historical development of ethics and individual-based bioethics in Western countries, and comparing that in China, this paper starts from the extreme Beijing Tongren Case and the dilemma in the reform of health system in the Chinese mainland, and puts forward the topics of bioethics and medical professionalism under the circumstances of globalization, global health, and global health system reform. It compares the individual-based bioethics in Western countries and the structure-based bioethics in the Chinese mainland, and discusses the lessons of structure-based bioethics for other countries. The histori-cal experience of health system reform in the Chinese mainland indicates that the health care system is welfare in nature, which is crucial; that the welfare health care system is the systematic foundation of medical professionalism; that there should not be direct economic interest generated in doctor-patient re-lationship since the marketization of health financing may lead to not only the structure intension of doc-tor-patient relationship, but also a total collapse of the medical professionalism. Therefore the Health Fi-nance rather than Health Economics should be the material foundation of medical professionalism. Th