醫學在大學聯考時被歸屬在第三類組，所修習的也都是自然科學典範下知識。然而，醫療的對象是人，加上疾病的複雜性與風險的不確定性，使醫療逐漸成為強調醫病互動的一門藝術，並成為社會科學關注的領域。Parsons將醫師與病人作為一種社會體系，以生病角色的概念，分析醫療的社會功能，在1950年代晚期將醫療社會學帶進社會學理論之中，美國社會學學會也於1962年成立醫療社會學部門，Journal of Health and Social Behavior成為ASA的正式刊物。
醫療社會學是一門應用性高而且在地性很強的學科，牽涉到個人、專業人員、醫療組織、社會文化、國家體制等面向，各種醫療現象與組織發展有其歷史脈絡與文化背景，不分階級貴賤都脫離不了生老病死的問題，無論從醫學或是從社會學出發，皆透露著強烈的現實關懷。Strauss(1957)指出醫療社會學有兩個研究方向，一個是醫學的社會學(sociology of medicine)，是以醫療為經驗研究的對象，目的是驗證或發展社會理論，關懷的是社會學的問題；另一個是醫學中的社會學(sociology in medicine)，則是利用社會學的觀點和研究方法來探討醫療現象，關切的是諸如疾病的就醫行為、醫囑遵循度等，以增進醫療服務的應用取向為主。
70年代以後，社會學對於專業主導的醫療體制提出許多批判，生物醫學知識如何建構疾病和健康的概念，直接挑戰了專門化知識主導的醫療權威。基於對醫療專業與生物醫學模式的批判，醫病之間互動的關係，也不同於Parsons所描繪客觀中立的醫師，將科學知識傳遞給被動無知的病人的模式。醫師與病人之間的關係，其實是帶有衝突性質的動態協商過程，雙方都力圖傳達彼此對情境的定義。因此，許多社會學研究採取病患的觀點，強調病患本身的就醫經驗，從知識與權力的角度，剖析醫病之間的行動。現在，醫界面臨了全球性經濟衰退，人口老化與新興科技帶來醫療費用高漲的財務困境，加上消費者意識抬頭，使醫病關係緊張甚至出現對醫療專業的信任危機，開始了以病人為中心的轉向，非醫療相關的社會因素越來越受到重視。Strauss對醫療社會學的區分已經沒有意義，身為社會學者無法再將醫療單純視為一個用來解釋社會現象的案例，而是要有能力解讀生物醫學資訊，了解醫療體系運作的邏輯，才有資格挑戰醫療專業權威，深入醫病互動過程的核心。
然而，對社會系學生而言，醫學猶如一座難以攻破的白色巨塔，不僅醫學文獻生澀如外星語言，複雜的醫院組織內有各種職系的專業人員，陀螺似地每天轉來轉去。即便你找到門路克服藩籬進入醫院進行田野工作，若是不了解醫療運作的模式，便很難與這群專業人員進行互動。正因為如此，許多社會學家只能透過問卷或次級資料庫研究，不容易進行深刻的生命經驗探索與直接的行動觀察分析。
本課程分為健康與醫療兩大部分，醫療的目的在維護生命與健康，但社會所產生的各種力量，往往比個人自身的決定與醫療行為更能影響我們的健康。首先要簡介健康在幾個主要面向的社會因素，包括階級、性別、種族等，以及人口結構如家庭、生活型態、老化等因素對健康的影響。其次是探討健康與疾病的關係，從生病經驗與病人角色出發，討論社會學是如何理解健康、如何定義疾病，並將醫療化與生活風格醫療放入課程，思考醫療在現代社會中對個人生命治理的影響。最後我將以多年臨床醫師的角度，分享從醫師的觀點是如何處理醫病之間的互動，並以組織社會學的理論分析現代醫院組織的運作，希望有助於對醫療議題有興趣的同學在進行醫院的田野時，能夠較為熟悉與去除陌生的恐懼感。除了健康、疾病、醫病關係、醫院組織幾大議題，最後會將焦點放在政府政策，特別是全民健保以及未來可能的長期照護政策，對提供照護的組織，以及照護者或受照護者的行動與經驗將產生的影響。
When medical studies were taken in college, they were classified as the third category, and they were all knowledge under the natural science classics. However, the target of medicine is people, and the complexity of the disease and the inconsistency of risk make medicine gradually become an art that emphasizes the interaction between medical diseases and a field of social sciences. Parsons used doctors and patients as a social system, using the concept of sick roles to analyze the social functions of the doctor. In the late 1950s, he brought medical society into social theory. The American Society also established the Medical Society Department in 1962, and the Journal of Health and Social Behavior became the official publication of the ASA.
Medical and social science is a highly applicable and highly local subject. It involves individuals, professionals, medical organizations, social culture, national systems, etc. Various medical phenomena and organizational development have their own historical and cultural backgrounds. No matter whether they are of grade or grade, they cannot escape the problems of birth, old age, sickness and death. Whether developed from medicine or society, they all reveal strong concerns. Strauss (1957) pointed out that medical society has two research directions. One is the sociology of medicine, which is the object of medical research. The purpose is to verify or develop social theory, and what is concerned about social problems; the other is the sociology in medicine. medicine) uses social perspectives and research methods to explore medical phenomena. What is important is medical behavior and medical compliance for diseases, and mainly improve the application orientation of medical services.
After the 1970s, society has made many criticisms about the professionally-led medical system. How biomedical knowledge constructs the concept of disease and health directly challenged the medical authority directed by specialized knowledge. Based on the criticism of medical profession and biomedical model, the interaction between medical diseases is also different from the pattern of Parsons's visually neutral doctors, who pass on scientific knowledge to passive and ignorant patients. The relationship between the doctor and the patient is actually a dynamic consultation process with conflicting characteristics, and both parties strive to convey each other's definition of the situation. Therefore, many social studies take the patient's views, emphasize the patient's own medical experience, and analyze the actions between medical diseases from the perspective of knowledge and power. Now, the medical interface has faced a global economic recession, population aging and Xinxing Technology have brought about financial difficulties with rising medical costs, and coupled with consumer awareness, it has caused medical relations to be tight and even a crisis of trust in medical professions, and has begun a patient-centered turn, and non-medical-related social factors are increasingly being valued. Strauss has no intention of the division of medical society. As a social student, socialists can no longer view medical orders as a case to explain social phenomena. Instead, they must have the ability to understand biomedical information and understand the logic of the operation of the medical system so that they can have the qualifications to challenge medical professional authority and go deep into the core of the medical interaction process.
However, for social students, the medical watch is like a huge white tower that cannot be broken. Not only medical and literary students are like alien languages, but the complex hospital organization has professionals from various departments, and it is like a gyroscope and it is transferred every day. Even if you find a gateway to overcome the feudal zodiac and enter the hospital for field work, it will be difficult to interact with this group of professionals if you do not understand the mode of medical operations. Because of this, many social scientists can only study through question papers or secondary databases, and it is not easy to conduct profound life experience exploration and direct action observation and analysis.
This course is divided into two parts: health and medical care. The purpose of medicine is to maintain life and health, but the various forces generated by society often affect our health more than individuals’ own decisions and medical behaviors. First of all, we need to introduce several main social factors that health is targeted, including level, gender, race, etc., as well as the impact of population structure such as family, lifestyle, aging and other factors on health. The second is to explore the relationship between health and disease, develop from the disease experience and the role of the patient, discuss how social science understands health and defines disease, and puts medicalization and lifestyle medicine into the course, and think about the impact of medicine on personal life governance in modern society. Finally, I will share from the perspective of a clinical physician for many years, how to deal with the interaction between medical diseases from the perspective of a doctor, and analyze the operation of modern hospital organizations through the theory of organizational society. I hope that it will help students who are interested in medical issues to be more familiar with and eliminate strange fears when they are in the field of hospitalization. In addition to the major issues of health, disease, medical relations, and hospital organizations, the focus will eventually be on government policies, especially universal health insurance and possible long-term care policies in the future, which will have an impact on the caregiver’s and the actions and experience of the caregiver or the carer.
1 William C. Cockerham（何斐瓊譯），2013，《醫療社會學》（Medical Sociology 12/E），雙葉書廊。
2 Barry and Quill（郭寶蓮譯），2009，《健康社會學導讀》（Understanding the Sociology of Health），韋伯文化。
3 David Wainwright（游卉庭譯），2012，《健康的社會學視界》（A Sociology of Health），韋伯。
4 Peter Conrad（許甘霖譯），2015，《社會醫療化：論人類境況如何轉為可治之症》（The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders），巨流。
5 張苙雲，2009，醫療與社會：醫療社會學的探索(第四版)，巨流。
1 William C. Cockerham, 2013, Medical Sociology 12/E, Double Leaf Library.
2 Barry and Quill (Reported by Guo Baoli), 2009, Understanding the Sociology of Health, Veber Culture.
3 David Wainwright (Reprinted by You Huiting), 2012, "A Sociology of Health", Wei Bo.
4 Peter Conrad (安容生女), 2015, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, The Medicalization of Society: On the Trans
5 Zhang Fengyun, 2009, Medicine and Society: Exploration of Medical Society (Fourth Edition), The Great Stream.
| 評分項目 Grading Method | 配分比例 Grading percentage | 說明 Description |
|---|---|---|
| 出席率、平時表現出席率、平時表現 Attendance rate, daily performance |
30 | |
| 分組報告分組報告 Sub-group report |
20 | |
| 期中報告期中報告 Midterm Report |
20 | |
| 期末報告期末報告 Final report |
30 |
