The Revolution of Medical Thoughts and the Development of Medical Sociology in Contemporary America

自古希腊延续至今的医学思想，在七十年代美国社会的S受到了革命性的巨变。人们质疑医生的任意权，坚持病人的自决权，而不是医生操纵的对象。在知情同意的基础上，医患双方的共同决策逐渐制度化。本研究的目的是分析医学思想革命的现实条件，并弄清医学社会学引领医学思想革命的发展过程。我曾试图阐明美国第二代医学社会学家，特别是蕾妮·C·福克斯、尤金·加拉格尔、安德鲁·特瓦德尔的学术努力的意义，并分析了总统医学和生物医学与行为研究伦理问题研究委员会1983年第16卷的最终报告《医学和生物医学与行为研究中的伦理和法律问题研究》。对于日本没有接受医学思想革命的洗礼，没有将知情同意制度化的情况，我认为，如果我们借鉴美国在医学思想革命发展过程中的理论努力，我们可以取得丰硕的成果。作为本研究的结果，我可以明确以下几点：(1)由于先进的医学技术带来的问题，出现了许多争议，从而发展了哲学、神学、法理学、社会学和医学的跨学科研究。(2)医学社会学在批评生命伦理学的个人主义偏见和自决权绝对化方面发挥了非常重要的作用。在此基础上，通过实地调研，具体明确医患关系的变化。

The medical thoughts, has continued since ancient Greece, has received the great revolutionary change at the 70's of American society. People questioned the arbitrary power of doctors and insisted the right of self-determination of patients, not the objects of manipulation by doctors. Then gradually, the shared decision making of doctors and patients was institutionalized, based on the informed consent.The aims of this study are to analyze the real conditions of revolution of medical thoughts, and to make clear the developmental process of medical sociology leading the revolution of medical thoughts. I have tried to elucidate the meanings of academic efforts of the second generation of American medical sociologists, especially Renee C.Fox, Eugine Gallagher, Andrew Twaddle as well as to analyze the Final Report on Studies of the Ethical and Legal Problems in Medicine and Biomedical and Behavioral Research by the President's commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 16 vols, 1983. As regard to the conditions of Japan not receiving baptism of medical thoughts revolution, not institutionalized the informed consent, I think we can get the great fruits if we throw the light on American theoretical efforts during the development of medical thoughts revolution.As the results of this study, I can make clear the following points.(1) There appeared a lots of disputes about problems presented by the advanced medical technologies, then developed the interdisciplinary research of philosophy, theology, jurisprudence, sociology, and medical sciences.(2) Among them, medical sociology play the very important roles to criticize the individualistic bias and the absolutization of the right of self-determination of bioethics. On the basis of these results, I would advance to make clear the change of doctors-patients relationship concretely by the field research,