從不平等到照護實作：監獄與健康的社會學取徑

From Inequalities to Care Practices: Sociological Approaches to Prison and Health

監獄及醫療都是重要的社會機構，而位於兩者相接之處的監獄與健康議題，常引起臺灣社會議論。討論多半以法律、醫學和公共衛生專業為主，鮮少有來自社會學視野進行的辯論。本文回顧既有對監獄與健康議題的社會學研究，區分出四種社會學分析取徑，說明其社會學核心議題、研究方法與介入策略。一、監禁與健康不平等，解釋監禁與社會不平等如何影響受刑人的健康；二、致病的監獄機構，批判受刑人所身處的環境與監獄制度，才是造成不健康的主要來源；三、監獄的醫學知識運作，闡明醫學知識對受刑人的分類、評估、與處置，呈現監獄的權力／知識運作；四、監獄照護實作，檢視監獄機構如何進行照護，以凸顯出監獄中懲罰與照護的矛盾，和實作過程的不確定性。藉由提出具有社會學視野的取徑和研究議程，我期許具備社會學取徑的研究，能對監獄與健康提出更周全的討論，尋找到介入監獄與健康議題的有力建言。

In Taiwan, disputes are frequently triggered when the social institutions of prison and medicine intersect, but most debates are rooted in law, medicine, or public health without insightful sociological input. A review of the sociology literature on prison and health reveals four analytical approaches to core issues, methodologies, and intervention strategies: (a) ways that incarceration and social inequalities shape and influence prisoners’ health; (b) critiques of how prisons and associated environments are root causes of health issues; (c) ways that in-prison power/medical knowledge classifies, evaluates, and treats prisoners; and (d) a “prison care practices” approach that examines how care is provided in punitive institutions, highlighting contradictions among care, punishment, and uncertainties in field practices. The author argues that sociological approaches can support a more comprehensive understanding of prison health issues and interventions.