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題名 | 醫「用」關係的知識與權力=Knowledge and Power in Professional-User Relationship |
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作者姓名(中文) | 成令方; | 書刊名 | 臺灣社會學 |
卷期 | 3 2002.06[民91.06] |
頁次 | 頁11-71 |
專輯 | 「醫療與社會」專題論文 |
分類號 | 419.47 |
關鍵詞 | 醫病關係; 知識; 權力; 多元認同; 婦產科; Doctor-patient relationship; Knowledge; Power; Multiple identities; Gynecology; |
語文 | 中文(Chinese) |
中文摘要 | 醫病關係長期以來深受詬病,近年來醫界也開始出現反省的聲音。本文提出以「醫 用關係」的思考模式來重新思考這個醫療社會學中的核心議題。「醫用關係」中的醫療專業者 不限於醫師,還擒括護士與其他醫療專業者;而醫療使用者則包括所謂的病患與尋求醫訊的 民眾。「醫用關係」的思考可以讓我們看到一個比我們熟知的「醫病關係還更複雜的圖像:在 診療情境具有相當的「不確定性」的情境具有相當的「不確定性」的情況下,加上醫療者和 使用都是「多重認同的主體」,他們之間的互動具有多樣知識交流和微觀權力運作的關係。因 此,筆者主張不再以病人的滿意度和醫病洲通中的遵從醫囑為研究對象,而以知識和權力為 「醫用關係」的問題核心之一。筆者以婦產門診的經驗研究來說明,醫用互動時,在知識交 流方面,包括了醫學知識、社會論述與個人隱微的知識。至於權力的連用,不是完全如我們 預設的來自單方面醫療專業者,醫療使用者也會採取策略進行協商、挑戰甚至乾胞出走。本 文的討論其望給予醫療專業者反省思考的空間,而使用者也可以認知到有充權的可能性。 |
英文摘要 | The doctor-patient relationship has long been the target for critics, and some reflexive views on the topic recently emerging from the Taiwanese medical profession. In this paper, I propose using the 'professional-user relationship' as an alternative approach to analyzing this core medical sociology issue. Here the professionals include doctors, nurses and other paramedical staff, while the user population consists of patients and others using medical resources. I believe the ' professional-user relationship' as it is generally understood. Due to the uncertainty involved with medical diagnoses and treatment, and given the fact the both professionals and users are subjects of multiple indentities, interactions between the two are filled with various kind of knowledge and took place at micro-power level. I therefore argue in favor of shifting the current research focus from patient satisfaction and compliance to professional-user's knowledge and power. The gynecological encounters between the professionals and users serve as examples illustrating the nature of knowledge and power involved in such in-teractions—knowledge including biomedical knowledge, social discourses and tacit knowledge held by individuals, and power meaning held by professionals as we usually assumed as well as held by users adopting strategies to negotiate outcomes, challenge decisions or simply turn to other choices. The discussion aims to provide the professionals with ideas for reflection and to show users a possibility of empowerment. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。