對稱化醫療社會學：STS對健康、醫療與疾病研究的啟發

What can STS do for Medical Sociology? A Symmetrical Inquiry into Social Studies of Health, Illness and Medicine

健康、醫療與疾病在STS與醫療社會學領域都是重要議題。因為各自學科起源、發展與著重點不同，兩學科對這些議題有不同研究取徑與思考角度。相較於醫療社會學的悠久與龐大傳統，STS的貢獻不只在於提出新議題。本文旨在藉由STS的對稱性思考，提供新架構，定位研究取徑，並藉在地醫療現實重新釐清本地研究成果與可能發展方向。醫療社會學已有兩波類似的對稱思考。本文進一步推展第三、四波的對稱化：首先由醫療實作角度，釐清醫療實作的異質性、多重中介、知識與技術體制，以及更為反身性、整體性地反省醫療研究本身的知識治理問題。其次，本文更後設地反思、重新連結被學科化的多種疾病與健康研究區隔，以及指出本地醫療社會學被高度生物醫療化。本文以經驗本體論層次的對稱性思考，基於本地的重要中醫現實指出「我們未曾全然生物醫療化」的問題性與展望。綜合這些層次，本文認為STS有助拓展醫療社會學的知識空間，以更為彈性、開放、帶有反身警覺性地考察多變的醫療、疾病與健康。

Health, illness and medicine are important topics both in science, technology and society studies (STS) and sociology, but they are explored with different approaches and focuses in the two disciplines. Compare to the long-established medical sociology, STS can offer more than new research topics. This paper follows the symmetrical method developed in STS and provides a framework for expanding medical sociology and mapping local studies. Based on the two similar symmetrical moves in medical sociology, this paper advances the third and fourth ones. It proposes to examine, firstly, the heterogeneity, multiple mediations, and the socio-medical regime in medical practices, and, secondly, the fact that local medical sociology is biomedicalized and it does not recognize the prevalence of Chinese medicine in Taiwan. Thus this paper applies the perspective of empirical ontology to such local medical context and proposes the problematic of “we have never been completely biomedicalized.” It is argued that the symmetrical method and STS perspectives are useful in elaborating much more open knowledge spaces for medical sociologists while attending to the changing realities of health, illness and medicine.