現代醫學的生命與身體觀：醫學生在大體解剖課程中的感知游移／猶疑   全文下載

The Conception of Life and Body in Modern Medicine: Reflections on Medical Students’ Encounters with Cadavers in Gross Anatomy

本文以訪談醫學生參與大體解剖課程的經驗做為探究的出發點，呈現當學生從抽象人體知識進到與個別身體遭逢時所產生的各種情感、價值與信念衝突，並從中反思現代醫學的人觀與身體觀預設，以及其對於生命與身體的知識建構與實際操作。本文首先論證，西方現代醫學典範所建構的解剖學身體雖然被剝除生命歷史與情感脈絡，但學生與身體的遭逢經驗卻鮮明呈現出生命身體與物理身體、精神與物質、倫理關懷與技術操作之間的交織牽引，顯示身心二元論與機械論身體觀試圖以死的身體做為活人的認識範式所隱含的內在緊張以及理解上的不足。其次則藉由詹納（Richard Zaner）等人對於現代醫學與肉身化（embodiment）的討論，以及現象學的「物體」（Körper）與「身體」（Leib）概念為線索，闡釋那些交錯層疊於大體解剖過程當中的多重身體意涵，進而為醫學教育與臨床倫理困境進行較深刻的揭露與反思。

The conception of human person and body in medicine has received more attention recently. Instead of a pure theoretical analysis, this study, utilizing in-depth interviews with medical students, discloses medical students’ perceptions and experiences as they encounter the human body in cadaver dissection course, and further examines the ways in which the notion of human body has been constructed and practiced in modern medicine. I contend that the students’ oscillations between lived body and physical body, spirit and matter, present and past, life and death, medical objectivity and humanitarian values which emerged in the gross anatomy laboratory lead us to thematize the inadequacy of mind-body dualism and mechanistic conception of body. Moreover, I draw on the analysis of embodiment developed by Richard Zaner and others and the phenomenological notion of Körper and Leib to elaborate the multiple senses of human body and the students’ ambivalence of perceiving the cadaver. Finally, I conclude that the epistemological problem of modern medicine should be addressed through the philosophical reflection on body, which enables us to better understand the difficulties facing medical education and clinical ethics.