“怎麼老是[吐大氣]”——台語語碼轉換於台灣醫學人文教育傳遞的意象值與語用功能探討

透過觀察台灣三位醫學人文講師的華語講課箝入台語的現象，本文建立一套量化語碼轉換正負意象值的分析架構，並搭配質性言談分析，以了解台語語碼轉換所傳遞的意象值分布及其於醫學人文教育的意義。主要發現有三：中性意象最常見、其次為負意象、正意象（54.6%，34.3%，11.1%）；三組語義範疇（健康、情緒、與一般）均為負意象高於正意象;台語語碼轉換單位多為「連續子句」而且出現情境多與「提及病方、引述醫病對話」相關，甚少為講者對人事物的負面評論。據此，我們得出三個論點:（1）對台語流利之醫學人文教育者，台語為其南部行醫的核心語言；（2）台語既是其全方位之教學語言，「以台語呈現醫療負意象」也是鋪陳醫學人文教育重要性之必要言談策略；（3）上述特徵有別於而且反駁了一般對「台語負意象」的刻板印象。

Based on Mandarin medical humanities lectures by three physicians, this study established a framework to quantify senses associated with code- switching into Taiwanese (CST), and analyzed their distribution pattern and pragmatic functions in the lectures. We have three main findings. “Neutral sense” associated with CST is the most common, followed by negative and positive senses (54.6%, 34.3%, 11.1%). A consistent pattern of more negative than positive sense occurs in the health, emotion, and general semantic domains. Consecutive CST clauses more frequently convey “reference to patients” or “quoted speech” from doctor-patient dyads than negative comments on a topic. Accordingly, for Taiwanese-speaking medical humanities educators in Southern Taiwan, Taiwanese is their core clinical language. CST achieves the same comprehensive functions as Mandarin and highlights the importance of medical education. The above refutes the general negative stereotypes associated with CST.