以傅柯知識權力觀點論述健康團體角度下的戒檳榔行為

Behaviors of betel nut cessation from the perspective of health professionals: Discourse of Foucault’s theory of power-knowledge

Foucault 知識權力論認為權力的運作不能只看制度性的權力或階級權力，而忽略日常生活中綿密的微視權力(micro－power)網絡。自1992 年至2011 年間，許多專家學者投入檳榔衛生教育成效及嚼食檳榔相關研究，其目的乃期望降低民眾對檳榔致癌物質的接觸。但在檳榔相關醫療政策執行及宣導的過程中，大多數研究以「客觀」的數字資料與「科學」的研究報告等權威式觀點，來建立專業醫療思維立場的科學主張。然而這種以單向傳播訊息，期待民眾成功戒除檳榔的方式，顯然忽略檳榔使用者生活經驗及社會脈絡觀點之重要性。本文運用傅柯(Foucault)知識權力哲學論述觀點，檢視健康專業制度式的權力型態與嚼食者之社會脈絡及文化的微視權力間之關係。

Foucault’s theory of power-knowledge claims that exercise of power mustnot focus only on people’s systemic or hierarchy power while neglecting their micro-power network from daily lives. Through the years of 1992 to 2011, many scholars have studied related topics about betel nut consumption, betel nut chewing behavior, and the effects of health education, in an attempt to prevent people from becoming exposed to the carcinogenic substance in the betel nuts. In the process of introducing and conducting health policies on the programs of betel nut consumption and cessation, most studies have used authoritative points to dictate their research findings with “objective” data or numbers and the so-called “scientific” view to establish their scientific perspective of medical professionalism. Apparently, the way of using one directionalcommunicating pattern to expect people to quit betel nut chewing successfully, neglects the importance of the experience of the betel nut chewers and the perspectives of their social network. With the philosophic view of Foucault’s theory of power-knowledge, we investigate the relationship between the systemic power of the health professionals and the micro-power from the social and cultural network of the betel nut chewers.