HIV/AIDS防治中的医患交往艺术——一个景颇村寨中的信任表达

The Art of Interaction between the Doctor and the Patient in HIV/AIDS Prevention and Cure:the Expression of Trust in a Jingpo Village

本世纪以来,中国各艾滋病重度流行地区的防治运动往往面临着过度"行政依赖"的制度困境,然而,本文在中国西南边境线上的一个景颇村寨中发现了例外。当地的官方防疫体制通过在终端启用代理人——乡村医生——来进行实际干预,极大规避了阳性群体对于防疫体制的过度依赖,以及由此造成的消极的社会道德后果。来自田野的事实证明,围绕着防疫实践的医患交往在信任机制的组织下,不仅柔和了官方防疫体制与对象间的文化张力,还通过策略而技巧的实践过程增强了对阳性人群的控制能力,并反过来强化了医患间的信任纽带。总的来说,医患间的交往艺术让医学权力的运作得以情境化,实现了社会控制的本意。

HIV/AIDS-inflicted regions in China have long been too dependent on the administrative power in their prevention practices. However, there is an exception. In a Jingpo Village on the Southwest border of China, prevention is handled by village doctors who are chosen by the official epidemic-prevention system for their intimacy with their patients and the great trust between them. Our field research shows that HIV-positive patients feel more comfortable with the doctors they know and will more readily succumb to their care. The cultural intensity between the official epidemic-prevention system and the HIV-positive patients is greatly softened by the intermediacy of the trusted village doctors. The art of the interaction between doctors and patients does help to substantiate medical power and realize social control.