身心障礙醫療化的在地經驗與反思

Reflections on the Medicalization of Disability in Taiwan

西方身心障礙研究常用「醫療模式」與「社會模式」，來區分現代社會對身心障礙看法與態度的轉變。過去十幾年來台灣身心障礙研究，以及實務工作者也多認同此典範轉移。然而台灣醫療模式與社會模式在實作上並非二元對立，很多時候兩者似乎是相互滲透，構成一種擴散式的、由醫療專業與非醫療人員共同的社會控制體系。身心障礙醫療模式的鑑定作為進入社會模式的門檻，這個表面上看似弔詭的安排，其實也是諸多制度間銜接與溝通的媒介。本研究首先探討身心障礙醫療模式的內涵，其次利用次級資料、法規檔案與訪談資料，呈現台灣身心障礙醫療化的在地樣貌，來對台灣身心障礙的醫療模式與社會模式在地樣貌進行反思。

The transition from the medical model to the social model has signaled an important shift in the understanding of the disabled in Western societies in the last four decades. In the past ten years, disability researchers and practitioners in Taiwan have also taken up this paradigmatic change; however, as they have been put into practice in Taiwan, the medical model and social model do not seem to contradict each other. Instead, these two approaches constitute an expansive social control system that includes medical and non-medical professionals. Examination based on the medical model is the gateway into services based on the social model. This seemingly ironic combination has shaped the connections and communications between disability-support institutions in Taiwan. This study will first examine the concepts behind the medical model, and then explore and reflect on the configurations of the medical and social models in Taiwan.