當專家遇見專家-經痛女性的西醫就醫經驗

When "Experts" Meet the Medical Professionals: The Women with Menstrual Pain Encountering Western Medicine

林秀怡(Shiou-Yi Lin)

指導教授 ： 成令方

高雄醫學大學/護理學院/性別研究所/碩士(2006年)

https://doi.org/10.6832/KMU.2006.00073

摘要

本論文的標題，當「專家」遇見專家，指的是「具有經痛體現知識的女性專家」遇見西醫醫療專業者時，兩種專家間進行「知識/權力」互動與交流的過程。過去台灣的女性主義者探討月經、經痛與醫療的研究，多半將焦點放在對過度醫療化的批判上；或採用行動策略、團體經驗分享等方式，喚起女性的月經意識，重塑女性對於月經的正向看法。此類研究雖然看見過度醫療化的問題與限制，但對於正在使用醫療資源或是需要使用醫療資源的經痛女性經驗卻鮮少著墨。

在本研究中，筆者以質性研究的方法，訪談十四位經痛且曾經就醫的女性，佐以參與觀察、訪談醫師與醫療文獻等方法，並依據訪談資料進行分析。藉由經痛就醫女性的經驗分享，讓我們看見經痛體現知識複雜，且具有多元的內涵；而這也是她們在面對西醫醫療專業者建議時，能夠判斷建議的實用性與並展現其能動性的重要基礎。其次，在帶著個人專屬的經痛體現知識的女性專家與西醫醫療專業者互動過程間，我們能清楚看見她們如何展現主體性與能動性：例如，由決定進入醫療系統開始，就能依照其不同動機與需求，選擇就醫場所與醫師；在醫用互動間，她們也不是被動聽從醫師指示的，而是以自身的經痛知識與醫療知識相互檢証、交流的過程；在就醫後也能運用策略巧妙地將西醫轉變成對己有用的資源，在這過程中醫療不再是主導而轉成輔助的位置。

經痛就醫女性的經驗，除了讓我們重新檢視醫療化對女體操控的問題外，也提供如何將醫療主導權回歸到個人身上、彈性使用醫療資源的可能性；除此之外，以經痛女性為主體進行研究，發掘女性的經痛知識內涵以及肯定女性作為身體專家的特殊性，也與女性主義知識論相互呼應。更重要的是，透過研究她們的經驗，一方面能讓醫療界重視到她們的需求，提供將來相關研究不同的思考角度與發展空間。另一方面，能讓女性經痛醫療使用者充權（empowerment），讓她們更有能力使用必需依賴的西醫醫療體系，在與醫療專業者互動時能獲得充分的資源與幫助。

關鍵字

經痛 ； 痛經 ； 醫用關係 ； 醫療化 ； 體現知識 ； 性別

並列摘要

The title of the dissertation is ‘When “experts” meet experts’. It means women who suffered menstrual pain hold embodied knowledge became experts and encounter the western medical professionals. The two kinds of experts carry on a dialogue involving “power/knowledge” relationship. In the past, Taiwanese feminist researches focused their criticism most on medicalization, or adopted action research and experience sharing in groups to wake up women’s consciousness and tried to rebuild the positive image of menstruation. There is very little discussion about the experience of women who would use the medical resources and in need of medical care.

By applying qualitative research methods, I have interviewed fourteen women with painful menstrual experience and two medical professionals. We find that the embodiment knowledge of menstrual pain is very complicated and varied. These women are able to judge the applicability of the medical treatments given by the medical professionals and demonstrate their autonomy by relying on their rich embodied knowledge. Second, during the interactions between women experts and western medical professionals, we can see how those women practice their subjectivity and agency clearly. When they decided to seek doctor’s help, and chose clinics and doctors according to their different needs. During the meeting with the medical professionals, they do not blindly follow doctor’s instructions. Instead they use their rich embodied knowledge to examine medical knowledge, and adopt various methods to maximum medical treatments to their specific conditions. In the process, Western medicine is no more the dominant but the assistant one.

Examining the experiences of these women not only gives us an insight to the problems of over medicalization, but also offers various ways to the women how to recapture the autonomy and how to use medical resources with flexibility. Besides, the research on women’s embodied knowledge further approves the status of women being the experts of her own menstrual pain; it corresponds feminist epistemology. More important, the research aims to draw the attention of the medical science to women’s needs and expecting a different kind of research developing in the near future. Moreover, the research expects to empower women suffered menstrual pain, so that they could use the medical resources to their own benefit.

並列關鍵字

menstrual pain ； dysmenorrheal ； professional-user relationship ； medicalization ； embodied knowledge ； gender

參考文獻

中文部分

田聖芳等 (1997)《實用婦科護理》，台北：匯華圖書

成令方 (2002)〈醫「用」關係的知識權力〉，《台灣社會學》，3：11-71。

曲同光 (1990)《基層醫療醫病關係之研究-著重於醫師態度及行為之探討》，國立台灣師範大學衛生教育研究所碩士論文.

吳嘉苓、黃于玲 (2002)〈順從、偷渡、發聲與出走：「病患」的行動分析〉，《台灣社會學》，3：73-117.