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題名：順從、偷渡、發聲與出走：「病患」的行動分析
書刊名：臺灣社會學
作者：吳嘉苓 引用關係／黃于玲
作者(外文)：Wu, Chia-ling／Huang, Yu-ling
出版日期：2002
卷期：3
頁次：頁73-117
主題關鍵詞：發聲與出走；權威知識；居家分娩；性別；Albert O. Hirschman；Exit and voice；Authoritative knowledge；Planned home birth；Gender
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(23) 博士論文(3) 專書(2) 專書論文(1)
  • 排除自我引用排除自我引用:22
  • 共同引用共同引用:343
  • 點閱點閱:376
　　　　　本文探討臺灣「病患」（醫用者）作為一個行動者，在面對需求不滿的情況時種種 回應的樣態，以及影響這此異質樣態，以及影響這些異質樣態的原因。我們提出「順從、偷 渡、發聲與出走」這個理解醫 行動的敗類根念，然後藉由臺灣本土的經驗研究探討，整理出 「不限於順從、仍難得發聲」的臺灣醫行動模式。偷渡、發聲與出走的存在，讓我們看見醫 用者參與醫療體系不只限於「順從」的類型，但是最能讓組織迅速有效地面對問題的行動模 式「發聲」卻並不常見。接著，我們藉由探索權威知識的形成過程，嘗試解釋影響醫用者行 動的關鍵因素，以臺灣計畫性居家分娩這個「發聲型出走」的出現做為分析案例。我們發現， 從主流的權威知識另立新局，必須有另一套有系統的知識體系。早期居家分娩婦女的宗教信 念提供了這樣的知識系統。當邊緣的權威知識想要建立可信度，論述者身份似手特別重要。 早期幾位關鍵產婦的高文化資本，也使這個模式得以迅速建立其可信度。同時，身體經驗成 為發聲與出走的的資本；產婦以身體理解原有規訓體系的後果，也以身體確認居家分娩的可 信度。最後，國際母乳會組織，以其互助的特質，擴展了這些產婦的社會資本，增加其選擇 生產方式的資源。我們看見行動者善用其文化資本、身體經驗與社會資本，可能匯集出的能 量。這也說明未來要理解臺灣醫療體系的樣貌，「病患」的行動角度絕無法缺席。
　　　　　This paper addressee the issue of how Taiwanese "patients" (now referred to as medical users) respond when they are dissatisfied with the health care they receive. Based on our revision of Albert o. Hirschman's ideal type of action into an "acceptance, stealth, voice and exit" analytical framework, we found that users are not simply accepting the status quo. They actively adopting various strategies in response to poor care, yet they seldom voice their dissatisfaction. Thus, the most direct and effective mechanism for expressing discontent does not affect recuperation. To analyze why responses vary and what conditions might increase the potential for voicing concerns, we use the example of planned home birth in Taiwan in the late 1990s to show how the formation of authoritative knowledge impacts action of medical users. We find that religious beliefs provide women oritative knowledge impacts action of medical users. We find that religious beliefs provide women with a sold foundation for exploring alternatives to authoritative knowledge. In addition, the cultural capital provided by the first women to participate in home births is serving to strengthen the model's credibility. Furthermore, women's bodily experiences are confirming the negative aspects model's credibility. Furthermore, women's bodily experiences are confirming the negative aspects of hospital births and the benefits of home birth. We also suggest that Taiwan La Leche League chapter is extending the social capital of home birth women and influencing the increased flow of resources to other women who want to give birth to their children at home. The specific social and historical contexts making home birth possible are also discussed. We conclude by stressing the importance of viewing medical users as key actors in the analysis of the medical system.
期刊論文
1.蘇燦煮、鄧素文、楊雅玲(19950600)。接受生殖科技治療婦女所曾尋求受孕之醫療及民俗療法的型態與歷程。護理研究，3(2)，127-137。new window  延伸查詢new window
2.Rusbult, Caryl E.、Zembrodt, Isabella M.、Gunn, Lawanna K.(1982)。Exit, Voice, Loyalty and Neglect: Response to Dissatisfaction in Romantic Involvements。Journal of Personality and Social Psychology，43(6)，1230-1242。  new window
3.陳秋瑩、張淑桂、紀駿輝、陳世堅、李卓倫、賴俊雄(19990300)。臺灣地區民眾使用中醫門診服務的因素之調查。中國醫藥學院雜誌，8(1)，77-87。  延伸查詢new window
4.林南(2000)。Inequality in Social Capital。Contemporary Sociology，29(6)，785-795。  new window
5.Lamont, Michele、Lareau, Annette(1988)。Cultural capital: Allusions, gaps and glissandos in recent theoretical developments。Sociological Theory，6(2)，153-168。  new window
6.Lin, N.(1982)。Social capital: Its origins and applications in modern sociology。Annual Review of Sociology，24(1)，1-24。  new window
7.范碧玉、李淑宜、葉英堃、林秀霞(19930400)。精神疾病患者就醫行為研究。公共衛生，20(1)，83-98。  延伸查詢new window
8.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
9.楊舒琴、盧孳艷(20001000)。臺灣婦女停經的身體政治。護理研究，8(5)，491-502。new window  延伸查詢new window
10.楊文山(19920600)。臺灣地區民眾求醫行為之分析。榮總護理，9(2)，121-125。new window  延伸查詢new window
11.許木柱(19920600)。民俗醫療與醫護因應。榮總護理，9(2)，117-120。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.吳嘉苓(20010200)。空間、規訓與生產政治。國立臺灣大學社會學刊，29，1-58。new window  延伸查詢new window
16.成令方(20020600)。醫「用」關係的知識與權力。臺灣社會學，3，11-71。new window  延伸查詢new window
17.Moore, Gwen(1990)。Structural Determinants of Men's and Women's Personal Networks。American Sociological Review，55(5)，726-735。  new window
18.章英華(19940600)。變遷社會中的家戶組成與奉養態度--臺灣的例子。國立臺灣大學社會學刊，23，1-34。new window  延伸查詢new window
19.Hu, Yow-Hwey、Wu, A. C. C.(1980)。Many ways to health: A study of 2,000 rural and urban Taiwan families。American Journal of Chinese Medicine，8(4)，310-330。  new window
20.張苙雲(1993)。工具理性與實質理性之間：剖析醫院醫療照顧的儀式性與迷思。中央研究院民族學研究所集刊，74，63-93。  延伸查詢new window
21.Fox, B.、Worts, D.(1999)。Revisiting the Critique of Medicalized Childbirth: A Contribution to the Sociology of Birth。Gender & Society，13(3)，326-346。  new window
22.Kemper, T. D.、Collins, R.(1990)。Dimensions of Microinteraction。American Journal of Sociology，96(1)，32-68。  new window
23.黃淑英、陳逸玲(1999)。RU486之謎－真相與假象。紫色姊妹，64，3-4。  延伸查詢new window
24.王美乃、毛新春、喻永生(1995)。胰島素依賴型糖尿病病童家長為其子女疾病尋求醫療之行為探討。公共衛生，22(2)，75-85。  延伸查詢new window
25.Munch, A.、McPherson, J. M.、Smith-Lovin, L.(1997)。Gender, Children, and Social Contact: The Effect of Childrearing for Men and Women。American Sociological Review，62(4)，509-520。  new window
26.Klassen, P. E.(2001)。Sacred Maternities and Postbiomedical Bodies: Religion and Nature in Contemporary Home Birth。Signs，26(3)，775-809。  new window
學位論文
1.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
2.蔡友月(1996)。現代社會對死亡的省思--以癌症病人為個案剖析垂死歷程"醫療化"之影響(碩士論文)。東海大學，台中市。  延伸查詢new window
圖書
1.Illich, Ivan(1976)。Medical Nemesis。Medical Nemesis。New York, NY：Pantheon Books。  new window
2.Freidson, E.(1970)。Profession of Medicine: A Study in the Sociology of Applied Knowledge。New York：Harper & Row。  new window
3.Oakley, Ann(1980)。Women Confined: Towards a Sociology of Childbirth。Oxford：Martin Robertson。  new window
4.瞿海源(1997)。台灣宗教變遷的社會分析。台北：桂冠。new window  延伸查詢new window
5.Jaggar, Alison M.(1983)。Feminist Politics and Human Nature。Rowman & Littlefield Publishers。  new window
6.Davis-Floyd, Robbie(1992)。Birth as an American rite of passage。Berkeley：University of California Press。  new window
7.Kitzinger, Sheila(1991)。Homebirth: The Essential Guide to Giving Birth Outside of Hospital。New York：Dorling Kindersley。  new window
8.Martin, Emily(1987)。The Women in the Body: A Cultural Analysis of Reproduction。Boston, MA：Beacon Press。  new window
9.Oakley, Ann(1984)。The Captured Womb: A History of Medical Care of Pregnant Women。Oxford：Basil Blackwell。  new window
10.Rich, Adrienne(1995)。Of Women Born: Motherhood as Experience and Institution。New York：W. W. Norton。  new window
11.Rothman, Barbara Katz(1982)。In Labor: Women and Power in the Birthplace。New York, NY：Norton。  new window
12.Wertz, Richard W.、Wertz, Dorothy C.(1989)。Lying-in: A History of Childbirth in America。New Haven：Yale University Press。  new window
13.Bourdieu, Pierre、Passeron, Jean-Claude、Nice, Richard(1990)。Reproduction in Education, Society and Culture。Sage Publications。  new window
14.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
15.Epstein, Steven(1996)。Impure Science: AIDS, Activism, and the Politics of Knowledge。Berkeley, California：University of California Press。  new window
16.Goffman, E.(1961)。Asylums: Essays on the social situation of mental patients and other inmates。London：Penguin。  new window
17.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
18.Hirschman, Albert O.(1970)。Exit, Voice, and Loyalty: Responses to Decline in Firms, Organizations, and States。Harvard University Press。  new window
19.Firestone, Shulamith(1970)。The Dialectic of Sex: The Case For Feminist Revolution。New York：Bantam Books。  new window
20.Bourdieu, Pierre、Nice, Richard(1990)。The Logic of Practice。Stanford University Press。  new window
21.Boston Women's Health Book Collective(1992)。The New Our Bodies, Ourselves。The New Our Bodies, Ourselves。New York, NY。  new window
22.Frank, Arthur、Frank, Arthur W.(1991)。For a Sociology of the Body: An Analytical Review。The Body: Social Process and Cultural Theory。London, UK。  new window
23.Williams, S. J.、Bendelow, G.(1998)。The Lived Body: Sociological Themes, Embodies Issues。The Lived Body: Sociological Themes, Embodies Issues。London, UK。  new window
24.楊秀儀(1997)。Medical Malpractice in Taiwan: Myth and Reality。Medical Malpractice in Taiwan: Myth and Reality。DSL dissertation。  new window
25.Rusbult, Caryl E.(1987)。Responses to Dissatisfaction in Close Relationships。Intimate Relationships: Development, Dynamics, and Deterioration。Newbury Park, CA。  new window
26.Ragin, C. C.、Becker, H. S.(1992)。What is a Case: Exploring the Foundations of Social Inquiry。Cambridge：Cambridge University Press。  new window
27.Jordan, Brigitte(1993)。Birth in Four Cultures: A Crosscultural Investigation of Childbirth in Yucatan, Holland, Sweden, and the United States。Waveland Press, Inc.。  new window
28.Epstein, S.(2000)。Democracy, Expertise, and AIDS Treatment Activism。Science, Technology and Democracy。New York, NY。  new window
29.(1997)。Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives。Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives。Berkeley。  new window
30.Szurek, J.(1997)。Resistance to Technology-Enhanced Childbirth in Tuscany: The Political Economy of Italian Birth。Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives。Berkeley。  new window
31.Szasz, T. S.、Hollender, M. H.(1987)。The Basic Model of the Doctor-Patient Relationship。Dominant Issues in Medical Sociology。New York, NY。  new window
其他
1.行政院衛生署(1999)。衛生統計，臺北。  延伸查詢new window
圖書論文
1.吳嘉苓(2000)。產科醫生遇上迷信婦女？台灣高剖腹產率論述的性別、知識與權力。性／別政治與主體形構。台北：麥田。  延伸查詢new window
2.Jordan, Brigitte(1997)。Authoritative Knowledge and Its Construction。Childbirth and Authoritative Knowledge。Berkeley：University of California Press。  new window
3.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
4.熊瑞梅(2001)。性別、個人網絡與社會資本。華人社會的調查研究方法與發現。香港：牛津大學出版社。  延伸查詢new window
 
 
 
 
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