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題名：醫「用」關係的知識與權力
書刊名：臺灣社會學
作者：成令方
作者(外文)：Cheng, Ling-fang
出版日期：2002
卷期：3
頁次：頁11-71
主題關鍵詞：醫病關係；知識；權力；多元認同；婦產科；Doctor-patient relationship；Knowledge；Power；Multiple identities；Gynecology
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(40) 博士論文(6) 專書(2) 專書論文(1)
  • 排除自我引用排除自我引用:38
  • 共同引用共同引用:322
  • 點閱點閱:523
　　　　　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。
　　　　　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.
期刊論文
1.林文源(20010200)。「醫療化」再思考。國立臺灣大學社會學刊，29，213-250。new window  延伸查詢new window
2.Waitzkin, H.(1984)。Doctor-patient communication: clinical implications of social scientific research。JMMA，252(17)，2441-2446。  new window
3.Zola, Irving Kenneth(1972)。Medicine as an Institution of Social Control。The Sociological Review，20(4)，487-504。  new window
4.Ong, L. M. L.、de Haes, J. C. J. M.、Hoos, A. M.、Lammes, F. B.(1995)。Doctor-patient Communication: A Review of the Literature。Social Science & Medicine，40(7)，903-918。  new window
5.許文耀、鍾瑞玫、陳秀卿(19970400)。醫病互動與醫囑遵循。公共衛生，24(1)，41-49。  延伸查詢new window
6.黃淑玲(20000700)。變調的「Ngasal」：婚姻、家庭、性行業與四個泰雅聚落婦女1960-1998。臺灣社會學研究，4，97-144。new window  延伸查詢new window
7.張菊惠、胡幼慧、張玨(19980400)。子宮切除術前醫師告知內容之研究。婦女與兩性學刊，9，115-144。new window  延伸查詢new window
8.林國明(19971200)。國家與醫療專業權力：臺灣醫療保險體系費用支付制度的社會學分析。臺灣社會學研究，1，77-136。new window  延伸查詢new window
9.Armstrong, David(1984)。The patient's view。Social Science and Medicine，18(9)，737-744。  new window
10.張玨、張菊惠(19980400)。婦女健康與「醫療化」：以停經期／更年期為例。婦女與兩性學刊，9，145-185。new window  延伸查詢new window
11.林國明(20010200)。歷史、制度與政策--臺灣醫療保險體系部份負擔與轉診方案的政策轉折。國立臺灣大學社會學刊，29，111-184。new window  延伸查詢new window
12.吳就君(19810400)。臺灣地區居民社會醫療行為研究。公共衛生，8(1)，25-49。  延伸查詢new window
13.張苙雲(19981000)。「逛醫師」的邏輯：求醫歷程的分析。臺灣社會學刊，21，59-87。new window  延伸查詢new window
14.Riessman, Catherine Kohler(1983)。Women and Medicalization: A New Perspective。Social Policy，14(1)，3-18。  new window
15.White, K. L.(1991)。Trend Report: The Sociology of Health and Illness。Current Sociology，39(2)。  new window
16.McKinlay, S. M.、Brambilla, D. J.、Avis, N. E.、Mckinlay, J. B.(1991)。Women Experience of the Menopause。Current Obstetrics and Gynaecology，1，3-7。  new window
17.Maseide, P.(1991)。Possible Abusive, Often Benign, and Always Necessary: On Power and Domination in Medical Practice。Sociology of Health & Illness，13(4)，545-561。  new window
18.Guiffre, P. A.、Williams, C. L.(2000)。Not Just Bodies: Strategies for Desexualizing the Physical Examination of Patients。Gender & Society，14(3)，457-482。  new window
19.盧孳艷(2000)。身體經驗與知識實踐－婦女另類更年期知識的產生。醫望雜誌（財團法人臺灣醫界聯盟基金會），33，99-102。  延伸查詢new window
20.藍忠孚、張淑桂、賴文恩、王玉潯、張文道(1997)。「門診病患對看診醫師滿意度」測量工具建立的研究。臺灣家庭醫學雜誌，7(1)，33-41。  延伸查詢new window
21.楊志良(1986)。醫院與病人關係為何跌入谷底？。中華民國公共衛生學會雜誌，177，34-37。  延伸查詢new window
22.王國裕(1997)。醫與病之間的看病文化。健康世界，142，88-96。  延伸查詢new window
會議論文
1.成令方(2000)。當女人與婦產科醫師相遇。臺灣2000性別與醫療工作坊會議。新竹：國立清華大學歷史研究所科技史組。  延伸查詢new window
學位論文
1.成令方(1997)。En/Gendering Doctors: Gender Relations in the Medical Profession in Taiwan 1945-1995(博士論文)。University of Essex，London。  new window
2.曲同光(1990)。基層醫療醫病關係之研究--著重於醫師態度及行為之探討(碩士論文)。國立臺灣師範大學。  延伸查詢new window
3.林文源(1998)。To be or not to be？長期洗腎病患的生活、身體經驗(碩士論文)。國立清華大學。  延伸查詢new window
4.陳君愷(1992)。日治時期臺灣醫生社會地位之研究(碩士論文)。國立臺灣師範大學，臺北。  延伸查詢new window
5.鍾國彪(1988)。公保門診醫師和病人互動之行為研究：病人滿意度和尊醫囑服藥行為的探討，臺北。  延伸查詢new window
6.詹麗綺(1987)。住院醫師與住院病人互動關係之探討，臺北。  延伸查詢new window
7.陳黛娜(1997)。產科醫護人員和病人滿意度研究－以某醫學中心為例，臺北。  延伸查詢new window
8.鄭麗寶(1990)。醫療過程中的人際互動的社會學分析，臺北。  延伸查詢new window
9.游祥祺(1989)。苗栗醫療區省立苗栗醫院特別門診病患滿意程度及其相關因素之研究，臺北。  延伸查詢new window
圖書
1.黃達夫(1999)。用心聆聽--黃達夫改寫醫病關係。臺北：天下遠見。  延伸查詢new window
2.Conrad, Peter、Schneider, Joseph W.(1980)。Deviance and Medicalization: From Badness to Sickness。St. Louis：C. V. Mosby。  new window
3.Waitzkin, Howard(1991)。The Politics of Medical Encounters: How Patients and Doctors Deal With Social Problems。The Politics of Medical Encounters: How Patients and Doctors Deal With Social Problems。New Haven, CT：Yale University Press。  new window
4.Mishler, E. G.(1984)。The discourse of medicine: Dialectics of medical interviews。Norwood, New Jersey：Ablex Publishing Corporation。  new window
5.Turner, Bryan S.(1992)。Regulating Bodies: Essays in Medical Sociology。London：Routledge。  new window
6.Freidson, E.(1970)。Profession of Medicine: A Study in the Sociology of Applied Knowledge。New York：Harper & Row。  new window
7.Silverman, D.(1987)。Communication and Medical Practice: Social Relations in the Clinic。London：Sage。  new window
8.Turner, Bryan S.(1987)。Medical power and social knowledge。Sage Publications。  new window
9.Foucault, Michel(1980)。Power and Knowledge: Selected Interviews and Other Writings, 1972-1977。New York：Pantheon。  new window
10.Nattleton, Sarah(1995)。The Sociology of Health and Illness。Cambridge：Polity Press。  new window
11.Polanyi, Michael(1967)。The Tacit Dimension。New York：M. E. Sharp Inc.。  new window
12.張珣(1989)。疾病與文化：臺灣民間醫療人類學研究論集。稻鄉出版社。new window  延伸查詢new window
13.Kleinman, Arthur(1980)。Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychi­atry。University of California Press。  new window
14.張苙雲(1998)。醫療與社會：醫療社會學的探索。台北：巨流。new window  延伸查詢new window
15.Young, Iris Marion(1990)。Justices and the politics of difference。Princeton University Press。  new window
16.Larson, Magali Sarfatti(1977)。The Rise of Professionalism: A Sociological Analysis。University of California Press。  new window
17.Armstrong, David(1983)。Political Anatomy of the Body: Medical Knowledge in Britain in the Twentieth Century。Cambridge University Press。  new window
18.Waitzkin, H.、Stoeckle, J. D.(1976)。Information Control and the Micropolitics of Health Care。Encounters Between Patientsand Doctors: An Anthology。Massachusetts。  new window
19.Turner, B. S.(1997)。Forward: From Governmentality to Risk, Some Reflections on Foucaults Contribution to Medical Sociology。Foucault, Health and Medicine。London, UK/ New York, NY。  new window
20.Turner, B. S.(1984)。The Body & Society。The Body & Society。London, UK。  new window
21.Parsons, T.(1951)。Illness and the Role of the Physician: A Sociological Perspective。Encounters Between Patients and Doctors。Massachusetts。  new window
22.Popay, J.、Williams, G.(1994)。Local Voice in the National Health Service: Needs, Effectiveness and Sufficiency。The Politics of the Welfare State。London, UK。  new window
23.Kaplan, S. H.、Greenfield, S.、Ware, J. E.(1989)。Impact of the Doctor-patient Relationship on the Outcomes of Chronic Disease。Communicating with Medical Patients。Newbury Park。  new window
24.Lock, M.(1993)。The Politics of Mid-Life and Menopause: Ideologies for the Second Sex in North America and Japan。Knowledge, Power & Practice: The Anthropology of Medicine and Everyday Life。Berkeley。  new window
25.Freidson, E.(1970)。Professional Dominance。Professional Dominance。N. Y.。  new window
26.Doyal, L.、Pennell, I.(1979)。The Political Economy of Health。The Political Economy of Health。London, UK。  new window
27.Fox, R.(1989)。The Sociology of Medicine: A Participant Observer's View。The Sociology of Medicine: A Participant Observer's View。New Jersey。  new window
28.Diprose, R.(1998)。Sexuality and Clinical Encounter。Vital Signs: Feminist Reconfigurations of the Bio/ logical Body。Edinburgh。  new window
29.Collins, R.(1990)。Changing Conceptions in the Sociology of the Professions。The Formation of Professions。London, UK。  new window
30.Australian National Health and Medical Research Council(1994)。General Guidelines for Medical Practitioners on Providing Information to Patients。General Guidelines for Medical Practitioners on Providing Information to Patients。Sydney, Australia。  new window
31.Armstrong, D.(1987)。Bodies of Knowledge: Foucault and the Problem of Human Anatomy。Sociological Theory and Medical Sociology。London, UK。  new window
32.趙柱英(1993)。春蝶再生。春蝶再生。臺北。  延伸查詢new window
33.(1988)。Gender and Discourse: The Power of Talk。Gender and Discourse: The Power of Talk。New Jersey。  new window
34.Szasz, T. S.、Hollender, M. H.(1956)。A Contribution to the Philosophy of Medicine: The Basic Model of the Doctor-Patient Relationship。Encounters Between Patients and Doctors: An Anthology。Massachusetts。  new window
35.Nelson, L. H.(1993)。Epistemological Communities。Feminist Epistemologies。London, UK。  new window
36.Freund, P. E. S.、McGuire, M. B.(1991)。Health, Illness, and the Social Body。Health, Illness, and the Social Body。New Jersey。  new window
37.Atkinson, P.(1978)。From Honey to Vigegar: Levi-Strauss in Vermont。Culture and Curing。Pittsburgh。  new window
38.賴其萬(2000)。當醫生遇見Siki。當醫生遇見Siki。臺北市。  延伸查詢new window
39.Jamous, H.、Peloille, B.(1970)。Changes in The French University-Hospital System。Professions and Professionalization。Cambridge。  new window
圖書論文
1.吳嘉苓(2000)。台灣病患權益運動初探。臺灣的社會福利運動。臺北：巨流。new window  延伸查詢new window
2.Davis, K.(1993)。Nice Doctors and Invisible Patients: The Problem of Power in Feminist Common Sense。The Social Organization of Doctor-Patient Communication。Ablex Publishing Corporation。  new window
 
 
 
 
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