本土精神病患照顧倫理的現象學探討

A Phenomenological Study of Domestic Nursing Ethics for Psychiatric Patients

本文先回顧過去的研究工作，其中包括對照顧存在性意義的探討、對詮釋現象學方法的省察，以及對醫護倫理意義的揭示等內容。在研究中也覺察到現象學與心理學間之緊張度與可能的化解方式，這歸於胡塞爾與海德格或以超驗現象學或以基礎存有論的立場與方法，其中二者哲學裡之超越概念需被確實理解。今在這些基礎上，再對於本土精神病患照顧倫理的議題來探討，採取的方法為對於國內研究本土精神病患照顧或醫護之一些文獻做檢視。本文中選取三位國內學者：文榮光、吳就君與黃嬡齡的實務研究工作，其分別為對本土精神病患之靈魂附身現象做觀察、對本土精神病患家屬的情緒表達做研究，以及對本土精神病患照顧之社區營造做探討。本文評以文榮光雖有詮釋現象學之立場，但未能以現象學方法探得根本的病因與醫治方式；吳就君雖有現象學立場與精神，但其研究方法尚待商榷；黃嬡齡則以田野質性方法探得的理念可呼應漢娜鄂蘭（Hannah Arendt）重視行動生活（vita activa）的思想。故本文將現象學從胡塞爾、海德格，經漢斯優納斯（Hans Jonas）擴延至鄂蘭的哲學意涵，從而方法上、討論議題上皆有所轉變。最後本文再從鄂蘭思想檢討現象學與心理學透過公共領域中之行動生活而可結合的可能。

The paper first reviews previous works, which include research on the existential meaning of caring, examination of the hermeneutic phenomenological method, and exploration of the meaning of medical ethics. There is a certain tension and a possible loosening between phenomenology and psychology due to Husserl's transcendental phenomenology and Heidegger's fundamental ontology with the implication that the concept transcendent needs to be correctly seized upon. On this basis, ethical issues pertaining to mental health nursing in Taiwan are discussed through examination of three psychiatric nursing and therapy studies relating to spirit possession in psychiatric patients, the emotional expressions of families of the psychiartric patients, and the social constructions of psychiatric patients. The first takes a hermeneutic phenomenological position, but does not make use of phenomenological methods and thus cannot discover the essential cause or the cure for the illness. The second study possesses a phenomenological attitide, but the method is not phenomenological. The final study makes use of qualitative field data and corresponds with the idea of vita active, which Hannah Arendt emphasizes. The article concludes by expanding the content of phenomenology from Husserl, and Heidegger via Hans Jonas to Arendt with variations in methodology and (subject matter). Possible synthesis of phenomenology and psychology from the viewpoint of Arendt is discussed.