醫療倫理社會實踐的思考－「醫療正當作為」考察芻議

Thinking the Praxis of Medical Ethics Preliminary Discussion on the Investigation of ＂Medical Righteousness＂

陳敏郎

《人文社會與醫療學刊》 5期 (2018/05) Pp. 31-52

摘要

醫療/健康需求行為及其相關體制的開展，已成為彰顯並影響社會發展的一種重要的社會實在。本文的目的，是希望能在認識醫療倫理社會實踐的相關理解、批判與反省等論述之外，進一步探討彰顯其社會實踐的可能途徑。健保規範、病人需求與醫院管理等多重限制，常是醫師對於臨床倫理表現與發展感到無奈和悲觀的因由。基本上，可能也是醫師臨床執業面臨「倫理兩難」、「醫病關係不良」等醫療言行困境的重要癥結。「醫療正當作為」做為試圖理解台灣醫療場域運作形態與影響機制的一種概念建構，指向建立一種「以實踐為基礎並指向實踐」之整體性觀點的認識基礎與研究目的。

關鍵字

社會實踐 ； 醫療倫理 ； 醫療言行 ； 醫療正當作為

並列摘要

The progresses of health behaviors and medical institutions have been seen as an important social reality for the developments of modern society. The purpose of this article is to recognize the analytic, critical discourses of medical ethics, and illuminate the possible images of the praxis of medical ethics. Physicians feel frustration and pessimistic for the practice of clinical ethic because of the various reasons including norms of National Health Insurance Institution, patients' needs, and hospital's management and so on. The ＂ethical dilemma＂, ＂harmful effect of patient-physician relationship＂ seems reveal the difficulties of medical practice for the physicians. ＂Medical righteousness＂ refers to a conceptual constructions, the aim is to comprehend the ways and mechanisms of Taiwan's medical field's operations. ＂Base on praxis and refers to praxis＂ is the main problematic, illuminating the practical forms of ＂medical righteousness＂ and overall concerning the praxis of medical ethics.

並列關鍵字

praxis ； medical ethics ； medical practice ； medical righteousness