本研究關心的是現代社會中的死亡意義建構問題,以安寧論述此一新興死亡與醫療議題作為批判性案例,探討其如何影響社會中死亡的整體論述型構,同時也釐清從西方傳入的安寧論述如何與本地既存論述相互構連、援引或對抗,瞭解安寧論述與本地社會文化之間關係。 本研究從語言(隱喻)及社會文化之進路切入分析。首先,透過隱喻分析以比較策略檢視從現代醫療論述到安寧論述用以詮釋死亡的隱喻中強調什麼面向,忽略哪些面向?反映什麼意涵?分析顯示,現代醫療論述詮釋疾病與死亡的隱喻系統乃機械隱喻與軍事化隱喻,帶領人們以敵意及不安的態度看待疾病與死亡。安寧論述中之隱喻系統則是自然現象隱喻與路途/旅程隱喻,透過此二隱喻系統,安寧論述將死亡自然化並彰顯死亡的不可避免性,疾病與臨終過程的痛苦面向則被隱藏。從現代醫療論述到安寧論述,不同概念隱喻使用方式其實並不只意味語言用法的改變,而是投射社會看待死亡之觀點與作為的轉變。 其次,本研究也發現,源自西方的安寧論述至少與現代醫療、宗教與民俗信仰、家庭、消費者權利論述等社會既存論述產生關聯與對話,這實也展現論述間的互文性。安寧論述所建構之臨終與死亡文化觀點是架構在社會既存論述與生死觀點上,而得以說明理念宣稱及融入本地社會文化。 總結來說,本研究認為,死亡的研究應開始嘗試探問在不同的時代與社會脈絡中,人們如何討論、想像、建構死亡,面對死亡的態度為何,並挖掘這些思考與意義建立如何反映某時代獨特社會秩序、集體心態及價值觀。本研究藉由探討安寧論述之死亡意義建構,及與社會文化的關係,所強調的是,在任何意義建構過程中,人們賴以生存與思考的社會文化總扮演核心角色。
This thesis concerns about the social construction of death in modern society. In This research, we apply hospice care discourse for a critical case to discuss how it plays an important part in the discourse formation of death in modern society and interprets the relationships between hospice care discourse and our local cultures. Firstly, this research applies metaphor theory to find out how people figure out the meaning of death form modern medical science discourse to hospice care discourse. We find the metaphoric concepts in modern medical science discourse are mechanical metaphor and military metaphor which think death is dreadful and must be resisted. And the metaphoric concepts in hospice care discourse are natural phenomena metaphor and road/ journey metaphor which imply the ineluctability of death. Secondly, hospice care discourse from western countries tightly connected to the discourses of modern medical science, religion, family and consumer rights in our society. It shows the intertextuality between hospice discourse and our cultures. Finally, this research argues that the researches about death must try to ask how people discuss death, face death and construct the meaning of death, to reveal how the construction of meaning reflects the social order and culture values. We argue that in any process of meaning building, the cultures we live by play important roles.
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