醫療體制與醫院組織的“相互再生產”－以基督宗教醫院組織行動特質的變與不變為例

The Processes of "Reciprocal Reproduction" between Medical Institutions and Activities of Hospital in the Case of Active Characteristics of Christian Medical Organizations

陳敏郎(Min-Lang Chen)

《人文及社會科學集刊》 17卷3期 (2005/09) Pp. 521-564

https://doi.org/10.6350/JSSP.200509.0521

摘要

宗教與醫療之間有著既古老又傳統的關係。醫療的宗教起源及其社會本質，對於醫療文明發達史的建構，也一直具有一定的影響力。基督宗教醫院組織所體現的醫療行為，在台灣醫療環境或醫療產業的發展經驗中，一向有著相當程度的歷史與社會經濟意義。當然，在醫療場域逐漸結構化的過程中，宗教與醫療之間的關聯程度也不斷地在改變。在健保體制已然成為台灣醫療場域最主要的制度性結構的情境之下，很明顯地，除了健保資源的爭取之外，經營能力的增進、宗教使命的傳達，乃至卽有之社會意象的延續與再造，都是基督宗教醫院組織維繫其在台灣醫療場域的生存位置與競爭能力的重要職能。
整體而言，基督宗教醫院組織行動特質「變與不變」的基本樣貌，事實上即體現在必須同時回應「健保資源的爭取」、「財務能力的要求」、「傳教使命的堅持」以及「社會意象的營造」等面向的共變關聯時，對於卽有之政治、經濟、文化與社會等資源的動員、累積與再分配的整體過程之中。兼顧上述諸面向發展的「一致性」，說明了基督宗教醫院組織仍能維繫其角色與地位的條件，同時也是展顯其行動特質「變與不變」的基礎。而在「相互再生產」的整體過程中，基督宗教醫院組織對於卽有之政治、經濟、文化與社會資源的動員、累積與再分配的過程、方式與結果，也將體現本文從「社會做為一個整體」的觀點，來看待基督宗教醫院組織行動特質之「變與不變」的分析意涵。

關鍵字

基督宗教醫院組織 ； 相互再生產 ； 功能與反功能作用 ； 社會做為一個整體

並列摘要

The traditional relationships between religion and medicine influenced the development of medical discipline. Starting a hundred years ago, Christian medical organizations revealed their historical and social meanings in the development of Taiwan's medical environment. The ”structured and structuring” process of medical field will revise the past relationships of religion and medicine.
The processes of ”reciprocal reproduction” between National Health Insurance Institution (NHII) and Christian medical organizations are represented in the following dimensions: pursuit of the resources of the NHII, requirement of financial ability, carrying out religious purposes, and construction of social image. The ”coherence” of activities mentioned above not only influences the existent opportunities of Christian medical organizations, but demonstrates their active characteristics as well.
In the processes of ”reciprocal reproduction”, the forms and effects of mobilized, accumulated and redistributed political, economic, cultural and social resources reveal and reform the active characteristics of Christian medical organizations. From this article, comprehending the possibilities and limitations of the active characteristics of Christian medical organizations will express the significance and analytical meaning of the perspective of ”the society as a whole”.

並列關鍵字

Christian medical organizations ； reciprocal reproductions ； functional and dysfunctional effects ； perspective of the society as a whole

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