医学化的驱动力量及其悖论

The Driving Forces of Medicalization and Its Paradoxes

医学化是将以前的非医学问题定义为医学问题并给予医学干预的过程。在过去的半个世纪中,积极健康观念和疾病价值的多元化理解直接导致了医学化三大驱动力量的次第兴起,它们是以医生为代表的医学专业群体,以制药业为代表的医疗产业复合体和以患者、患者家属和患者团体为代表的非专业群体,由此带来了对医学化利弊的重新考量。然而,医学化的影响是复杂的,存在着无法自洽的解释悖论:其一是个体经验悖论,即一方面医学化提供了连接个体经验的平台,另一方面又加剧了个体的脆弱感和无力感;其二是个人责任悖论,即一方面医学化减轻了个人的疾病责任,另一方面,个人的健康责任却被大大强化。

Medicalization is the process of defining previously non-medical problems as medical problems and giving medical interventions.Over the past half century,positive health perceptions and diverse understandings of the value of disease have led directly to the sequential rise of the three driving forces of medicalization.They are the medical professional community represented by physicians,the medical industrial complex represented by the pharmaceutical industry and the lay community represented by patients,their families and patient groups.The rise of these three forces has forced the academic community to reconsider the pros and cons of medicalization.However,the effects of medicalization are complex,and there are paradoxes of interpretation that are not self-explanatory.One is the paradox of individual experience,that is,on the one hand,medicalization provides a platform to connect individual experience,but on the other hand,it intensifies the individual’s sense of vulnerability and powerlessness.The second is the paradox of individual responsibility,in which medicalization reduces individual responsibility for illness on the one hand,while on the other hand,individual responsibility for health is greatly enhanced.