脆弱性的資訊科技風險治理文化：考察病歷電子化之制度性無知

Vulnerable Culture of Info-technological Risk Governance: Examining the Institutional Ignorance to Electronization of Medical Records

本文主要串連一系列資訊科技策略脈絡（國民卡、按捺指紋、健保IC卡、病歷電子化），論證政府的決策與治理模式問題。從整理歷年社會之反資訊風險運動與病例外洩事件，我們凸顯在地社會的系統性風險將延續影響我國病歷電子化之治理問題。我們嘗試分析線性風險評估之決策模式，往往造成制度性的忽視外溢於技術層次之社會風險與溝通，並導致民眾對病歷電子化的無知。同時，進而形成風險感知的破碎化，使民眾無法真正的意識到其對個人、家族或族群隱私權利的侵害威脅。另一方面，此種破碎的資訊風險文化，不但不利於公民與社會之反身性治理，並將提高臺灣民眾的風險感知矛盾性。亦即，從歷次的公眾資訊風險感知調查結果來看，民眾一方面擔憂資料外洩與被政府濫用，但另一方面由於對資訊風險嚴重性的無知而輕易的掉入成本效益迷思，導致高度支持行政或商業部門單面向的資訊利用效益論述。而此種系統性風險（systemic risks）（OEDC, 2003）若持續深化，將使得整個社會愈形脆弱，並造成新興科技的治理轉型面臨高度的困境。其問題在於權威的專家政治、封閉式的菁英決策模式與管制文化，隱性而劇烈的形成特殊的隱匿、遲滯風險的治理系統，因而嚴重的忽略社會的質疑與要求。其最終結果，就是社會的風險感知的破碎化、脆弱度越來越高，甚至遠高於西方社會回應新興科技衝擊的脆弱性程度。

This article argued a series of problems in the governmental decisionmaking and governing pattern. Through sorting anti-informational risk movements and divulgence of medical records over the years, we featured the systemic risk affect the governing problems of electronization of medical records (EMR). We tried to analyze a decision-making pattern continued linear risk assessment and how it will lead to public ignorance on EMR. From results of several public information risk perception surveys, the publics worried about their data leaking or misusing, but fell into the myth of cost-efficiency analysis easily. Moreover, if the systemic risks (OECD, 2003) keep deepening, it will make the whole society more vulnerable and cause the governing transformation for newly technology facing serious struggles. The problem here is a social system hidden and delaying risk, formed by the authoritative expert politics, the closed elite decision-making pattern and the regulative culture, incapable of responding the societal requirements. Hence, the social vulnerability increases more and more, even higher than western society's to respond newly technological impacts.