新冠肺炎(Covid-19)在2020年造成全球重大的經濟與生命損失，也改變了人們習以為常的生活方式。原本以為只有極權國家才可能出現的封城令，居然也普遍地在歐美上演。自由與人權在疫情恐慌下讓位，居而代之的是口罩與社交距離，防疫優先成為政治正確的無上律令。不只進入醫院要量體溫，連上學、上班、甚至吃飯都乖乖地排隊量測體溫，足跡要被監控，上夜市也要查1968，醫療的凝視滲入生活的每一個細節，我們要如何以社會學的視角加以看待？
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。2010年，Journal of Health and Social Behavior醫療社會學50年專刋，Hankin於導論指出可以從以下幾個主題進行研究，包括：1. 健康照護的種族族群差異、2. 健康不平等的基礎原因、3. 壓力與健康、4. 社會關係與健康、5. 疾病的社會建構、6. 醫病關係與求診行為、7. 醫學專業的社會變遷、8. 健康照護研究、9. 科技、10. 生物倫理(bioethics)、11. 健康再造(health reform)。指出未來的研究方向應該更關注醫療改革所帶來的意圖與非意圖後果。
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。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。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。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。
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。第一個部分要討論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。第二個部分討論醫療的現代性，介紹現代醫院的運作方式，了解醫療品質以及病人安全的概念對醫師與其他職系專業化歷程的影響，醫療風險如何改變醫病之間的互動關係，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。
The new coronavirus (Covid-19) caused significant economic and life losses around the world in 2020, and also changed the way people take it for granted. City lockdown orders, which were originally thought to be possible only in totalitarian countries, are actually common in Europe and the United States. Freedom and human rights have given way to the panic of the epidemic, replaced by masks and social distance. Prioritizing epidemic prevention has become the supreme law of political correctness. Not only do people have to have their temperature taken when entering the hospital, but they also have to line up to have their temperature taken when going to school, work, and even eating. Their footprints are monitored, and even going to the night market requires a 1968 check. The medical gaze penetrates into every detail of life. How can we use sociology to Viewed from a different perspective?
Parsons regarded doctors and patients as a social system and analyzed the social function of medical treatment through the concept of the sick role. In the late 1950s, he brought medical sociology into sociological theory. The American Sociological Association also established Medical Sociology in 1962. Department, the Journal of Health and Social Behavior became the official publication of ASA. In 2010, Journal of Health and Social Behavior 50 Years of Medical Sociology, Hankin pointed out in the introduction that research can be conducted from the following topics, including: 1. Racial and ethnic differences in health care, 2. Basic causes of health inequality, 3. Stress and health, 4. Social relationships and health, 5. Social construction of disease, 6. Doctor-patient relationship and diagnosis-seeking behavior, 7. Social changes in the medical profession, 8. Health care research, 9. Technology, 10. Bioethics, 11. Health reform. It is pointed out that future research directions should pay more attention to the intended and unintended consequences of health care reform.
Medical sociology is a highly applicable and local subject, involving individuals, professionals, medical organizations, social culture, national systems, etc. Various medical phenomena and organizational development have their own historical context and cultural background, and No matter the class, no matter whether it is high or low, it is inseparable from the issues of birth, old age, illness and death. Whether from the perspective of medicine or sociology, they all reveal strong realistic concerns. After the 1970s, sociology made many criticisms of the professional-dominated medical system. How biomedical knowledge constructs the concepts of disease and health directly challenges the medical authority dominated by specialized knowledge. Based on the criticism of the medical profession and the biomedical model, the interactive relationship between doctors and patients is also different from the model described by Parsons in which objective and neutral doctors transfer scientific knowledge to passive and ignorant patients. The relationship between doctor and patient is actually a dynamic negotiation process with a conflictual nature, with both parties trying to convey each other's definition of the situation. Now, the medical community is facing a global economic recession, financial difficulties caused by rising medical costs caused by an aging population and emerging technologies. Coupled with rising consumer awareness, the relationship between doctors and patients has become tense and there has even been a crisis of trust in the medical profession. Patients have begun to As the center turns, non-medical related social factors are receiving more and more attention. As a sociologist, we can no longer regard medical care simply as a case used to explain social phenomena. Instead, we must have the ability to interpret biomedical information and understand the logic of the operation of the medical system. Only then can we be qualified to challenge the authority of the medical profession and delve into the interaction between doctors and patients. core.
This course is divided into two parts: health and medical treatment. The purpose of medical treatment is to maintain life and health, but various forces generated by society often affect our health more than individuals' own decisions and medical behaviors. The first part will discuss several major social factors of health, including class, gender, race, etc., as well as the impact of demographic structure such as family, lifestyle, aging and other factors on health. The second is to explore the relationship between health and disease, starting from the experience of illness and the role of the patient, discussing how sociology understands health and how to define disease, and incorporates medicalization and lifestyle medicine into the curriculum to think about the impact of medical treatment on personal life in modern society. Governance impact. The second part discusses the modernity of medical care, introduces the operation of modern hospitals, understands the impact of the concepts of medical quality and patient safety on the professionalization process of doctors and other grades, and how medical risks change the interaction between doctors and patients. It is hoped that It helps students who are interested in medical issues to become more familiar with and eliminate the fear of unfamiliarity when conducting fieldwork in hospitals. In addition to several major topics such as health, disease, doctor-patient relationship, and hospital organization, the final focus will be on government policies, especially national health insurance and possible future long-term care policies, on organizations that provide care, and on caregivers or care recipients. The impact that actions and experiences will have.
William C. Cockerham（何斐瓊譯），2013，《醫療社會學》（Medical Sociology 12/E），雙葉書廊。
William C. Cockerham (translated by He Feiqiong), 2013, "Medical Sociology 12/E", Shuangye Bookstore.
| 評分項目 Grading Method | 配分比例 Grading percentage | 說明 Description |
|---|---|---|
| 課前閱讀、出席課堂課前閱讀、出席課堂 Read before class and attend class |
30 | 學生務必出席課程，並依課綱進度所列文本擇一進行預習。出席狀況、隨堂的參與度、討論的發表等都將納入平時成績評分標準。無故曠課者, 每次扣學期總成績五分。 |
| 分組報告分組報告 Group report |
30 | 各組自行從每周的思考問題中選擇一個主題，上台導讀並帶領討論，分享如何以社會學的角度來看這個問題。 |
| 期末報告期末報告 Final report |
40 | 從本學期的課程主題中選擇一個主題，也可針對某一醫療社會學文獻進行讀書心得報告。一千五百字以上。 |
