把疾病帶回來？病患實作中的多元疾病客體化

Bring Disease Back In? Exploring Modes of Disease Objectification in Patients’ Practices

社會學已發展多種患病研究取徑，分析疾病的社會面。在近年跨界整合趨勢中，批評者指出「患病社會學」忽視疾病的特性、臨床指標與實務規範，因此倡議「疾病社會學」。本文回應此倡議，但進一步提出批判，指出問題不在於患病與疾病的區分與結合，也不能只帶回生物醫療的疾病。本文藉由科技與社會研究的實作本體論，以及相關客體化實作分析取徑，尤其是邊界客體與多重疾病概念，對稱分析多元醫療實作的疾病客體化，包括生物、中醫、偏方、超自然醫療體制，如何促成慢性腎病、證型、對應與超越疾病客體，以及各種交會模式。本文帶回多元客體化實作，藉此反省現有理論分析的限制，提出正視本地多元醫療—社會現實的社會學。 Medical sociologists have developed various paradigms for the social analysis of illness. Critics highlight that the sociology of illness reduces disease into social categories and ignores the specificity of diseases, clinical indexes, and practical norms and call for a sociology of disease. This paper critically follows the initiative without following the divide and convergence between disease and illness and bringing only disease back in. Drawing from practical ontology and studies of objectification practices, especially those of boundary and multiple disease objects, from science, technology, and society studies, this paper explores the multiple disease objects and modes of objectification symmetrically. By examining kidney patients’ multiple medical practices that interfere with each other, this study shows that we cannot bring the biomedical chronical kidney disease back in without taking multiple disease objects and modes of objectification into account. The conclusion examines the agenda of this approach, with a reflection on the specificity of existing theoretical tools, and proposes a sociology that faces multiple medical practices in a specific medico-social context.

Medical sociologists have developed various paradigms for the social analysis of illness. Critics highlight that the sociology of illness reduces disease into social categories and ignores the specificity of diseases, clinical indexes, and practical norms and call for a sociology of disease. This paper critically follows the initiative without following the divide and convergence between disease and illness and bringing only disease back in. Drawing from practical ontology and studies of objectification practices, especially those of boundary and multiple disease objects, from science, technology, and society studies, this paper explores the multiple disease objects and modes of objectification symmetrically. By examining kidney patients’ multiple medical practices that interfere with each other, this study shows that we cannot bring the biomedical chronical kidney disease back in without taking multiple disease objects and modes of objectification into account. The conclusion examines the agenda of this approach, with a reflection on the specificity of existing theoretical tools, and proposes a sociology that faces multiple medical practices in a specific medico-social context.