从病人话语到医生话语——英国近代医患关系的历史考察

From Discourse of the Patients to Discourse of the Doctors:the Historical Inspection on Doctor-Patient Relationship of Modern England

18世纪晚期至19世纪早期,英国医患关系发生重要变化,病人话语权的弱化成为其突出标志。现存的医案印证了这是一个渐变的过程,既是医疗自身的转变,包括临床医学诞生以及医院兴起等的一个结果,同时它也受社会历史的影响,可以视为工业化国家处理社会问题这一大背景下的一个缩微景观。文章从历史的角度探讨英国近代医患关系转型中的话语要素,揭示这一转变中所蕴含的医学与人文动因,并对医患关系、病人权力等问题进行了反思。

The relationship between doctor and patient has experienced important changes from late 18thcentury to early 19thcentury,the outstanding mark of which is the disappearance of patient＇s narrative.This is a gradual process verified by the existent medical casebook,which is the result of medical transformation,including the naissance of clinics and the rise of the hospitals,and also,which is influenced by social history and can be seen as the micro-scene of the industrial society＇s dealing with its social problem on a large background.This paper investigates the discourse element in the transformation of doctor-patient relationship from historical points and disclose the causes of medicine and humanities of this process,furthermore,the paper rethinks modern problems about doctor-patient relationship and patients＇ power and other relative problems.