規範市場、協商醫政與再造專業：戰後初期的臺灣省醫師公會，1946-1967

Regulating Market, Negotiating Policies and Remodelling Profession: Taiwan Medical Association, 1946-1967

許宏彬(Hsu, Hung Bin)

《科技醫療與社會》 30期 (2020/04) Pp. 163-216

https://doi.org/10.6464/TJSSTM.202004_(30).0004

摘要

醫師的社會及政治參與是臺灣近代醫療發展中的鮮明特徵。然而，戰後初期臺灣省醫師公會號召群醫集體參與政治之現象卻鮮為學界所討論。本文提出以下幾個問題：為何戰後醫師於二二八事件與白色恐怖陰影下，仍積極參與政治？其中，醫師公會做為法定專業代表機構扮演什麼角色？此現象與戰後醫療環境劇變、法規變遷及專業發展間有何關連？本文發現，殖民時期因總督府對市場高度管制加之對醫師團體的消極態度，故而臺灣開業醫普遍採取「自由業」心態，組織程度不高。戰後因政權轉移出現新醫療體制與大批新從業人員，開業醫面對醫業競爭及醫權不彰情形下，藉法定「臺灣省醫師公會」以集結因應。省公會一方面以專業倫理立場勸導開業醫加入團結對外，另一方面也以利益團體的身份要求新政權介入管制醫療市場。進行遊說與協商的過程中，公會發現須更積極介入政治方能有效管制醫療市場並確保醫權，因而鼓勵會員投入各階層選舉以彰顯醫界影響力，開啟戰後「政醫合作」時代。

關鍵字

醫療市場 ； 醫病關係 ； 醫學倫理 ； 專業化 ； 醫政關係

並列摘要

Taiwanese doctors' various social and political activities have drawn much attention from historians of Taiwan history. However, Taiwanese doctors' collective relationship with the medical market and the state after WWII remains unexplored. Focusing on the role of the Taiwan Medical Association (TMA), this paper raises the following questions: What kind of role did TMA play in shaping the post-war medical profession on the island? What is the relationship between doctors' political activities, the medical market and governmental policy? This article argues that, during the Japanese colonial period, the doctors did not and could not execute their collective influence on medical policy and, for the most part, remained freelancers. However, after WWII under the new Chinese Nationalist government, various kinds of medical practitioners were allowed into the market. To cope with the resultant chaotic and overcrowded market, doctors felt a strong need to unite under the auspices of the newly established TMA around a professional code of ethics that would strengthen their collective influence. Meanwhile, the TMA negotiated with different levels of government and the Legislative Assembly to regulate the medical market. It is in this particular context that TMA encouraged its members to become involved in various types of political elections with the aim of amending the medical regulations in their favour and thus tightening control over Taiwan's medical market.

並列關鍵字

Medical Market ； Doctor-Patient Relationship ； Medical Ethics ； Professionalization ； Medicine and Politics

參考文獻

《中國時報》（1979），〈修正勞保指定醫院辦法放寬承保醫療人數限制嚴禁向保險人 ‧ 收取保證費用違者加重罰鍰 ‧依法移送偵辦〉。5 月 30 日。

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