近十余年来，暴力伤医犯罪于多地频发，严重影响我国医疗事业的发展与社会的安定和谐。目前，我国关于暴力伤医犯罪的犯罪学研究尚处于起步阶段，存在一定不足。鉴于此，本文以暴力伤医犯罪为研究对象，运用数理统计法、案例分析法、跨学科研究法等方法，借助默顿的“社会结构-失范”理论分析这类犯罪的生成过程，以期在此基础上提出可行有效的犯罪预防对策。本文主要包括绪论和正文两部分内容。在绪论中，论述了研究的背景、意义和创新，梳理了现存的主要文献。正文包括以下三个部分：

第一部分对暴力伤医犯罪的基本特征和默顿的“社会结构-失范”理论进行描述与阐释。首先，界定本文所研究的“暴力伤医犯罪”的基本概念，明确样本选择标准，对暴力伤医犯罪裁判文书进行检索整理，运用描述性统计分析方法揭示这类犯罪的基本特征。其次，从社会结构的三个方面（即规范结构、机会结构和观念结构）、社会和个体两个维度及“失范”产生的三个阶段阐释默顿的“社会结构-失范”理论，指出该理论对于解析各类犯罪现象具有重要意义，并说明该理论对暴力伤医犯罪这一典型的失范现象具有解释力。

第二部分以默顿的“社会结构-失范”理论为基础，分析暴力伤医犯罪“由社会到个体”的生成过程。暴力伤医犯罪的生成过程包括犯罪酝酿、犯罪萌芽及犯罪发生三个阶段。在暴力伤医犯罪的酝酿阶段，导致暴力伤医犯罪发生的社会环境形成，表现为健康价值观与医疗制度规范分离，即医疗制度规范无法保障社会成员普遍实现健康价值观。在暴力伤医犯罪的萌芽阶段，可能实施暴力伤医犯罪的社会群体从全体社会成员中分化出来，表现为机会结构与医疗规范结构分离，即在上述社会环境中，部分社会群体可以利用社会地位上的优势通过制度规范实现健康价值观；其余社会群体仍然难以通过医疗制度规范实现健康价值观，更易感知来自健康价值观的压力，具有实施暴力伤医犯罪的潜在可能性。在暴力伤医犯罪的发生阶段，个体决定并实施暴力伤医犯罪行为，表现为观念结构与医疗规范结构分离，即承受文化目标压力的部分社会成员“拒绝”并以暴力“替代”目前的医疗制度规范，实施创新型暴力伤医犯罪；或者“拒绝”并以暴力“替代”医疗规范结构（包括医疗制度规范和健康价值观），实施反叛型暴力伤医犯罪。

第三部分以暴力伤医犯罪的生成过程为根据，兼顾预防措施的可操作性，提出有效可行的暴力伤医犯罪预防对策。首先，积极改善酝酿暴力伤医犯罪的社会环境。可以通过健全医疗救助制度、推动优质医疗资源下沉、完善卫生人才保障激励机制三个方面的措施优化医疗制度规范，避免健康价值观与医疗制度规范的分离，切断暴力伤医犯罪的酝酿进程。其次，以个体观念干预为核心预防暴力伤医犯罪发生。可以从改善医院软件硬件设施、加强院内院际医疗协作、疏通就医体验反馈渠道、重拾“关系医学”理念、妥善处理医疗事故、依法打击暴力伤医犯罪并辅以警示宣传等方面入手，实施个体观念干预措施，避免观念结构与医疗规范结构分离，有效预防暴力伤医犯罪的发生。

In recent ten years, violent crime against health workers have occurred frequently in many places, seriously affecting the development of our medical services as well as social stability and harmony. At present, the criminological research on violent crime against health workers is still in its infancy, and there are some deficiencies. In view of this, this paper takes violent crime against health workers as the research object, and uses the methods of mathematical statistics, cases analysis and interdisciplinary study to analyze the generation process of this kind of crime with the help of Merton’s Social Structure and Anomie Theory, in order to put forward feasible and effective countermeasures for crime prevention. Specifically, the content of this paper mainly includes the following three parts:

The first part describes the basic characteristics of violent crime against health workers and explains Merton’s Social Structure and Anomie Theory. First of all, define the basic concept of “violent crime against health workers” to clarify the sample selection criteria, retrieve and sort out the judgment documents of the crime, and use descriptive statistical analysis method to reveal the basic characteristics of this kind of crime. Secondly, explain Merton’s Social Structure and Anomie Theory from three aspects of social structure (namely, the normative structure, the opportunity structure and the ideal structure), two dimensions in society and individual, and three stages of “anomie”, point out that the theory is of great significance for analyzing various criminal phenomena, and show that Merton’s Social Structure and Anomie Theory has explanatory power for the typical anomie phenomenon of violent crime against health workers.

The second part is based on Merton’s Social Structure and Anomie Theory, analyzing the generation process of violent crime against health workers “from society to individual”. The generation of violent crime against health workers includes three stages: the brewing of the crime, the germination of the crime and the occurrence of the crime. In the brewing stage of the crime, the social context that leads to violent crime against health workers is formed. It is manifested in the separation of health values from medical institutional norms, that is, medical institutional norms cannot ensure that social members generally realize health values. In the germination stage of the crime, the social groups that may commit violent crime against health workers are differentiated from all social members. It is manifested in the separation of the opportunity structure from the medical norm structure, that is, in the above social context, some social groups can take advantage of their social status to realize health values through medical institutional norms; other social groups are still difficult to realize health values through medical institutional norms, and are more likely to feel the pressure from health values, and have the potential possibility of committing violent crime against health workers. In the occurrence stage of the crime, the individual decides and commits violent crime against health workers. It is manifested in the separation of the ideal structure from the medical norm structure, that is, some of the individuals who are under the pressure of health values “withdraw” and “replace” the current medical institutional norms with violence, and then carry out the innovative acts of violent crime against health workers, or “withdraw” and replace” the complete medical normative structure (including health values and medical institutional norms) with violence, and then carry out the rebellious acts of violent crime against health workers.

The third part is based on the generation process of violent crime against health workers, taking into account the feasibility of preventive measures, and proposes feasible and effective preventive measures for this kind of crime. First, actively improve the social environment in which violent crime against health workers is brewing. We can avoid the separation of health values from medical institutional norms to cut off the brewing process of the crime by improving the medical aid system, promoting the subsidence of high-quality medical resources and perfecting the incentive and protective mechanism for health personnel. Secondly, take the intervention of individual ideas as the core to prevent the occurrence of violent crime against health workers. We can implement measures to interfere with individual ideas to avoid the separation of the ideal structure from the medical normative structure and then effectively prevent the occurrence of violent crime against health workers by improving hospital software and hardware facilities, strengthening medical collaboration inter- and outer-hospital, dredging the feedback channel of medical treatment experience, reviving the concept of “relational medicine”, properly handling medical accidents, cracking down on violent crime against health workers according to criminal law with warning publicity.