“二十四孝”中的病人、家庭与医生——一个患病相关行为的医学社会学考察

Patient,Family and Doctor in Chinese Literature on Filial Piety:A Medical-Sociological Research

本文以元人郭居敬《全相二十四孝诗选》等"二十四孝"文献中的涉医内容为对象,运用医学社会学概念框架,探讨其中病人、家庭和医生共同卷入的患病相关行为特征以及对中国人就医行为和医疗模式的影响。分析表明,建立在现代医学基础上的西方概念框架对于研究中国人的传统患病相关行为可能并不完全适用。相反,种种在上述框架下被视为典型"问题行为"的做法,在中国社会文化背景下被认为是正当而且合适的,反映出中国传统就医模式和医疗观念的强大影响。以个人主义为基础的、现代意义上的医患关系,在传统中国社会并不存在。对于普通中国人来说,认为病人应"自我负责"的想法在传统上似乎并无普遍认知基础。这种以病痛为前提发展的依赖性亲密关系是高度躯体化取向的。这一取向下的"病人—家庭"一体化倾向是中国人传统就医行为的突出特点。

This study,which is based on the medical components in ancient Chinese literature on'the twentyfour cases of filial piety',explores the medical behavior patterns of Chinese patients,families and doctors in traditional society.Analysis suggests that modern medicinal conception may not apply to traditional Chinese medical behaviors.A variety of behaviors viewed as'problematic'in the modern conceptual framework may have been recognized as legitimate and proper in Chinese society and culture.Modern doctor-patient relationship based on individualism does not exist in pre-modern Chinese society in which individual patient is normally not held responsible for herself.The dependent intimacy developed from pain and sickness reveals a strong tendency of somatization,in which integration of patient and family is formed.