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題名:當照顧遇上科技:邁向照顧民主化?
作者:周宇翔
作者(外文):Chou, Yu-Hsiang
校院名稱:國立中正大學
系所名稱:社會福利研究所
指導教授:王舒芸
學位類別:博士
出版日期:2021
主題關鍵詞:照顧科技長期照顧照顧民主化民主關懷倫理care technologylong-term carecaring democracydemocratic ethics of care
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  隨著人口高齡化與科技的快速發展,近年各主要福利國家逐漸透過「照顧科技(care technology)」,作為解決照顧問題的解方之一。然而,目前文獻不僅忽略行動者觀點的多樣與異質性,同時也未能基於民主關懷倫理(democratic ethics of care)對於政治性(politics)的強調,關注階層化與權力關係,甚至將關懷觸角從場域內個別照顧關係,延伸至社會制度或政策層面。
  據此,本研究聚焦「照顧」、「科技」與「民主」的關係,同時以Tronto (2013)「照顧民主化(caring democracy)」為主要視角,透過訪談高齡者、家屬、長照人員、科技業者、政府部門代表及專家學者等44受訪者,聚焦兩個層面議題:(1)探討「照顧」與「科技」關係為何?科技如何促進長照實作?(2)探討「照顧」、「科技」與「民主」的關係為何?照顧科技是促進或阻礙「民主式照顧(democratic care)」形成?
  研究結果如下:(1)「照顧」與「科技」之間,並不是「溫度」的二分關係(dichotomy);而是立基「黏著性」概念,藉由「變動性與標準化/固著性」的劃分與建立,拓展兩者包容性。同時,科技的導入讓不同行動者,獲得情緒、身體與時間面向的益處。(2)雖然高齡者想握有對科技的主導與發聲權,但在家父長形式、自主權交讓及消權等因素下,往往成為(被)噤聲的群體。(3)鑲嵌在長照場域勞雇權力圖像的照顧科技,不僅讓本土與外籍勞動者受到排除與懷疑等壓迫;同時,配合新管理主義、照顧數據化以及無感監測,可能讓他們受到更強烈的績效監測與勞動監控。(4)新自由主義宣稱的完美照顧科技市場並不存在,需求端與供給端出現明顯的資訊不對等與落差,使得供給端握有科技發展的主導優勢地位。(5)照顧科技相關行政體系出現分立情況,同時相關措施及政策發展,以新自由主義標榜的「市場原則」為圭臬,使得科技應用出現產業化、階層化及責任個別化效果,政策面浮現出現去管制化聲浪。
  基於以上,本文一方面認為,台灣照顧科技的導入與發展,與民主化照顧的距離,似乎是千里迢迢的漫長路途。同時更主張,照顧科技不只是社會議題(減輕工作負擔、提昇生活品質)或經濟議題(成本效益、工作管理及產業發展),更是政治問題(權力分配、話語權與意識形態影響);我們應該透過更為民主及平等形式,讓各行動者雨露均霑地獲得科技導入效益。
In recent years, with an aging population and the rapid development of technologies, major welfare states have gradually come to adopt “care technology” as one of the solutions to care problems. However, presently, the literature not only ignores the diversity and heterogeneity of actors’ viewpoints, but also fails to focus on the relationship between hierarchy and power, based on the political emphasis of democratic care ethics, and even extends the tentacles of care from individual care relationships in the field to the social system or the policy level.
Therefore, this study focuses on the relationship among “care,” “technology,” and “democracy,” mainly from the perspective of “caring democracy,” a notion proposed by Tronto (2013). The 44 respondents interviewed in the study included elderly persons, their family members, long-term care workers, technology professionals, representatives of government agencies, experts and scholars, etc. The research questions addressed in the study are as follows: (1) What is the relationship between “care” and “technology”? How does technology promote the practice of long-term care? (2) What is the relationship among “care,” “technology,” and “democracy”? Does care technology promote or hinder the formation of “democratic care”?
The study results are as follows: (1) The relationship between “care” and “technology” is not mutually exclusive; it is based on the concept of “viscosity” and expands the inclusiveness of the two by division and by establishing “variability and standardization/fixedness.” At the same time, the introduction of technology allows different actors to gain emotional, physical, and time-oriented benefits. (2) Although the elderly wish to play a dominant role and voice their rights regarding technology, they often become the silent (silenced) group owing to factors such as patriarchy, transfer of autonomy, and disempowerment. (3) The care technology embedded in the employer-employee power map in the field of long-term care not only makes local and foreign workers oppressed by exclusion, suspicion, etc., but also, with the aid of new managerialism, care digitization, and sensorless monitoring, subject to more intense performance- and labor monitoring. (4) The perfect care technology market as claimed by neoliberalism does not exist. Moreover, there is significant information asymmetry and gap between the demand side and the supply side, with the supply side gaining dominance in the development of technology. (5) The development of measures and policies related to care technology is thus based on the “market principle,” flaunted by neoliberalism as the standard, causing the applications of technology to produce industrialization, stratification, and individualization of responsibilities, with the voice of deregulation appearing on the policy side.
Based on the above findings, this study, on the one hand, maintains that the distance from the introduction and development of care technology in Taiwan to a “caring democracy” seems inordinately long. On the other hand, it advocates that care technology is not only a social issue (reducing work burden and improving quality of life) or an economic issue (cost-effectiveness, work management, and industrial development), but also a political issue (power distribution, discursive power, and ideological influence). Therefore, we need to adopt a more democratic and equitable form of care technology, so that all actors can be equally benefited from the introduction of technology.
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