「侵犯」或是「斷裂」？醫療專業權力社會實踐初探

＂Interference＂ or ＂Interruption＂ Preliminary Discussions about the Praxis of Professional Power of Medicine

在健保體制下，醫療事務的公共化所引發的社會效應之一，即是表顯為對於醫療情境與醫師臨床作為的檢視與回應之相關認知的差異及其顯著化。本文認為，關於醫療專業權力社會實踐問題的討論，具有重新檢視與反省現代社會對於醫師社會形象與地位、臨床作為乃至專業素養等醫療言行之發展與變遷的重要意涵。本文一方面是關於健保體制下，醫界內、外對於醫療專業權力社會實踐的關注與討論；二方面則是進一步思考相關認知與行動對於醫療場域若干運作的可能影響。文中首先簡要討論醫療專業權力的若干發展與變化過程，舖陳現代社會爭議醫師生活言行問題與現象的可能背景及脈絡；其次比較與分析「醫師敘事」與「書寫醫師」相關論述對於醫師生活言行的爭議；第三則是提出相關爭議對於現代醫療場域發展的積極意義乃至可能出路的進一步思考。最後，本文將嘗試指出對於型塑「新」專業行動與素養之醫師生活言行的可能期待。

One of the social effects about the publicity of health affairs arose from evaluated and criticized the operations of medical practice in Taiwan's National Health Insurance institution. Besides, the discourses about the operations of medical practice revealed significant variances between ＂physician's narrative＂ and ＂writing physician＂. Scrutinizing the discussions about the praxis of medical power would manifest significant meanings for the thinking of developments and changes of social image, practice and discipline of physicians, as well as the improvements of medical practice in modern society. For the purposes of this article, understanding the various critical discourses about the praxis of medical power on one hand; on the other hand, making further thinking for the possible effects and influences of those discourses and relative actions to the operations of medical field. In this article, firstly, illustrating the developed processes of medical professional power and elaborating the possible contexts of the discoursesof the practice of physician. Secondly, illuminating the polemical discourses which between ＂physician's narrative＂ and ＂writing physician＂. Thirdly, figure out the energetic meanings of those controversies. And finally, trying to indicate the possibilities of construct and enable a new expertise of practice of physician.