医患关系的谱系学分析及社工介入的可为空间

A Pedigree Analysis of the Doctor-patient Relationship and Social Work’s Possible Intervention

当代医患关系紧张有着深层的制度原因。随着现代医疗制度的确立,医疗场域经历了由传统文化话语主导、现代民族国家话语主导到市场话语主导的转变,不同话语体系下的医患关系呈现不同特征。在传统话语与国家话语弱化的情况下,市场话语主导下的医患关系呈现出紧张与冲突的特征,这是制度变革与社会道德失序的双重结果。就医患关系的改善而言,制度设计与道德重建并非易事,因而通过社会工作对医患关系的介入实现危机预防与解决、关系修复与建设极为必要。

The strained relationship between medical workers and patients has its deep institution. al reasons. With the establishment of the modern medical system,the medical field has experience a transfer of discourse dominance from traditional culture,to modern nation-state,and to market. The characteristics of doctorpatient relationship vary in different discourse systems. When traditional and state discourses turn weak,this relationship,under the market discourse dominance,tend to be tense and contradictory,which is the result of the institutional change and the disorder of the social moral. It does not seem to be easy to improve the relationship simply through institutional design and moral rebuilding,but social work’s intervention can be vitally necessary in crisis prevention and relationship restoration and construction.