标准医生、百度病患与阐释-交往性医疗图景——技术语境下的医患关系个案研究

Standard Physician,Baidu Patient,and Interpretative-Communicative Medical Prospect——A Case Study of Physician-Patient Relationship in Technological Context

医患关系既被医疗制度正式地构建,也被包括医学在内的现代技术深刻地形塑。从自主神经紊乱病症患者Z姐就诊中的医患互动与健康日常可见,现代技术语境下的医患关系凸显麦当劳化的“标准医生”与网络自诊化的“百度病患”之对垒,即技术的“分割效应”使得临床实践标准化下的医生与多元信息裹挟下的病患之间不断产生矛盾与冲突。医患关系演化的逻辑部分在于,现代性技术发展导致医生作为疾病健康立法者的退场及社会公众的健康确定性期待,驱使医患关系由“神-人”关系渐变为“机-人”关系。未来的图景可能需要诉诸医生积极阐释者角色的转向、病患医学知识信念的重塑,以及医患主体性回归的“阐释-交往医患关系模式”,以扭转“机-人”式医患互动,缓解医患“交往困境”,构建和谐医患关系。

The doctor-patient relationship is not only formally constructed by the medical system,but also deeply shaped by modern technology,including medicine.From the doctor-patient interaction and healthy daily life of patient Z with an autonomic nervous disorder,the doctor-patient relationship in the context of modern technology highlights the confrontation between“Standard Physician”and“Baidu Patient”.The logic of the evolution of doctor-patient relationship is that the development of modern technology leads to the exit of doctors as disease and health legislators,and the public’s expectation of health certainty,which drives the doctor-patient relationship from“God-Man”relationship to“machine-man”relationship.The future picture may need to resort to the transformation of the role of doctors’active interpreters,the reconstruction of patients’medical knowledge and beliefs,and the“interpretation communication doctor-patient relationship model”of the return of doctors’and patients’subjectivity,so as to reverse the“machine-man”doctorpatient interaction,alleviate the“interpretative-communicative mode”of doctors and patients,and construct a harmonious doctor-patient relationship.