回到臨床場景的醫病對話：梅洛龐蒂立基於知覺身體的表達語言

醫療場景經常出現說不出口、說不清楚的狀況，是種特殊的間接語言，不同於我們一般觀點視語言為符應現實，是以我們需要另尋理論架構才能有所把握。本文擬採梅洛龐蒂立基於身體知覺基礎的現象學，探討醫療場景的語言現象。梅洛龐蒂的知覺現象學有別於傳統形上學的進路，並不是為了掌握變動不居的現實而將知識的基礎建立在永恆不變的絕對意識上，這樣的知識雖然達到普遍客觀的標準，卻脫離人們生活過的活生生生活情景，因此梅洛龐蒂予以批判強調意義實際上是有「身體」的基礎，是人類主體投入世界的具體存在，是以他探討的範圍也包括語言現象。因此，梅洛龐蒂探討語言的方式也與一般抽象命題的分析不同，他關切的語言在我們日常生活的分享，所以語言不是可以固定下來的靜態語言結構，相反的語言會隨著主體的使用而形成具體的情境脈絡而作為主體的表達，也就是說語言作為主體的實踐活動，成為實踐活動中發展出來的新的理性形式，語言同時包含有理論層面和實踐層面，為日後的實踐活動保留空間。梅洛龐蒂基於胡塞爾現象學的關懷，認識到語言作為主體描述現實，已然是主體自身存在模式的表達，但是就在梅洛龐蒂將語言立基在知覺的基礎上，他也覺察到這種奠基性模式的隱憂，像是限於原初表達主體規定的所指內容，但是作為主體的存在模式其實就是創造性的產物，已經超出個體主體的表達，於是他重新吸收索緒爾結構主義語言學的成果，將語言符號的操作歸於能指間的作用，成為可以超越起源時刻的自主結構，成為非關說話主體個體特徵或語言活動的語言與知覺交織的先驗空間，使得實踐的面向成為必要，並且只能在不斷進行的實踐活動中確立意義。這樣，醫療場景的對話不只是對現狀的描述，還在描述中包含主體情感向度的不滿與期待，是我們可以不斷的擴充、發展，尋找生命轉機的沃土。

關鍵字

梅洛龐蒂；索緒爾；語言；知覺；實踐理性；醫學倫理

並列摘要

Although psychological interrogation is still important in clinical therapy, the contemporary doctor does not pay attention to everything the patient says. In contemporary medical education, young doctors are taught to concentrate on symptoms that indicate bodily disorders. The problem is that patients and family members facing life and death situations often find it difficult to discuss their real feelings and needs. Dr. Zaner describes their discourse on such occasions as ”indirect language.” It doesn't directly correspond with reality. To handle such cases, we need to a new theory of language meaning that differs from the received correspondence theory. The present dissertation heeds insights from Merleau-Ponty's celebrated phenomenology of perception in working out a new approach to language. Merleau-Ponty knew well that language is not merely a vehicle that human beings use to describe reality; our language also exhibits the perspective through which we view and describe reality. That is, it could be argued that the speaker's language contains his or her feelings and desires-qua body subject-about the world. The speaker's language is, to some extent, the embodiment of him or her qua body subject. Merleau-Ponty attempts to found language on perception, and thus to show that the speaker's language use can be viewed as expressing what he or she originally intends to signify. Nonetheless, language also is a rational system, and thus expresses more than just what the individual speaker intends to say. Hence, Merleau-Ponty also incorporates Saussure's structuralist linguistics on the recognition that language use is at the same time the effect of linguistic signifiers, and thus becomes an autonomous system, seemingly without origin. In this regard, language becomes irrelevant to the individual speaker's personality or intended meanings; it creates an autonomous a priori space, i.e., a transpersonal meaning field. The present dissertation attempts to apply Merleau-Ponty's hybrid theory of language use to the explanation and understanding of dialogue in clinical situation, which includes indirect language use that not only describes what facts and events but also express the speakers' frustrations and expectations. This theory appears promising for casting light on such indirect dialogues which are indicators at turning points in people's life.