醫療的政治性：從社會、知識到本體論政治與本地醫療實作的本體論政治研究題綱

Politics of Medicine: From societal to epistemic and ontological politics, and a proposal for local research

本文結合醫療社會學以及科技與社會研究成果探討醫療的政治性。經由釐清醫療異質連結中的權力與權威安排，以及在其中發生的活動的研究成果，本文區分醫療的社會、認識與本體論政治性，以嘗試拓展本體論政治取徑，並提出本地多元醫療實作體制的研究題綱。本文指出，第一、醫療社會學在「社會化」疾病，創造患病的分析典範時，以醫療對非醫療事務的入侵、社會群體藉由醫療擴張權力等，指認醫療如何成為社會鬥爭的工具、場域與方法，發展社會政治批判。第二，在科技治理與公眾科技理解的認識論政治中，對稱化專家與常民的宣稱而深入醫療知識，強調不同認識模式的正當性競逐與分配中，各種利害關係人的知識構框與其價值。第三，本體論政治取徑探討異質實作，強調現實構成、我們共存的可能性條件，以及介入所形成的連結，如何造成存在模式、可能性條件競逐，與被實現的存在與價值差異。最後，本文指出拓展本體論政治的體制方向，並嘗試由多元醫療體制為例提出建議題綱。 This paper explores the politics of medicine illuminated in the studies of Medical Sociology and Science, Technology and Society Studies. Drawing on those researches, this paper not only specifies three modes of societal, epistemic and ontological politics, but also proposes an agenda for studying the ontological politics of local medical regimes. It is argued, first, that in the societal critiques of the invasion of medicine into social life, medicine is identified as the method, field and tool for social struggles. Second, in the epistemic politics of technoscientific governance and public understanding of science, the contested claims by both experts and lay people are symmetrically treated so as to investigate the differences of epistemic framings and the values of the various stake holders. Third, the ontological politics approach explores heterogeneous medicosocial practices. It emphasizes how the linkages made between the constitution of reality, the condition of possibility of our coexistence and our interventions enact the differences specific modes of existence and value. Finally, this paper proposes to extend the scope of the ontological politics approach with regime analysis for studying local medical regimes and practices.

This paper explores the politics of medicine illuminated in the studies of Medical Sociology and Science, Technology and Society Studies. Drawing on those researches, this paper not only specifies three modes of societal, epistemic and ontological politics, but also proposes an agenda for studying the ontological politics of local medical regimes. It is argued, first, that in the societal critiques of the invasion of medicine into social life, medicine is identified as the method, field and tool for social struggles. Second, in the epistemic politics of technoscientific governance and public understanding of science, the contested claims by both experts and lay people are symmetrically treated so as to investigate the differences of epistemic framings and the values of the various stake holders. Third, the ontological politics approach explores heterogeneous medicosocial practices. It emphasizes how the linkages made between the constitution of reality, the condition of possibility of our coexistence and our interventions enact the differences specific modes of existence and value. Finally, this paper proposes to extend the scope of the ontological politics approach with regime analysis for studying local medical regimes and practices.