死亡医学化的社会阶梯与文化抉择——基于云南省某市2009-2014年人口死亡地点分析

Social Gradient and Culture Alternative in Medicalization of Death

云南省某市的死亡人口统计数据表明,死亡地点分布呈现以职业地位、教育程度为基础的阶梯态势,阶位较高者更可能积极参与死亡医学化进程,而阶位较低者反而更可能回避作为健康消极结果的死亡医学化的侵袭。对阶位较低者而言,医疗可及性不足同样使他们的死亡以侵犯生命尊严的形式发生。同时,彝族等少数民族较汉族更可能死于家中,这相异于现代生物医学的死亡观念。临终文化实践可以帮助人们摆脱死亡医学化的阴霾,但这种可能性只发生于职工阶层。这表明人们对死亡医学化侵袭的能动因应,是以死者及其家庭拥有充分的经济和社会保障资源为先决条件的。该条件的普遍缺乏,能够解释为什么中国实现优逝善终的普遍性较低。

For examination of medicalization of death, this paper analyzes the data of places of deathamong X City in Yunnan Province. Social Gradient manifested by occupational status and educationbackground indicates the affinity of those occupied superior positions on the gradient with the process ofmedicalization of death. The incompatibility of those occupied inferior positions with medicalization process ofdeath stems from their lack of medical accessibility and results in death without life dignity. The conventionaldeath concept and dying practice model supply Yi nationality with culturally alternative way in escape ofmedical death, but work only if the dead or families have the benefit of financial capability and social securityto make them possible. The lack of this benefit takes part in low popularity of hospice in China.