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

从古希腊延续至今的医学思想，在美国社会的70年代发生了巨大的革命性变化。人们质疑医生的专断权力，坚持病人的自决权利，而不是医生操纵的对象。然后，渐渐地，医生和病人的共同决策制度化，基于知情同意。本研究旨在分析医学思想变革的现实条件，厘清医学社会学引领医学思想变革的发展历程。我试图阐明第二代美国医学社会学家，特别是Renee C.Fox, Eugine Gallagher， Andrew Twaddle的学术努力的意义，并分析医学和生物医学和行为研究伦理问题总统委员会1983年出版的《医学和生物医学和行为研究中的伦理和法律问题研究的最终报告》，16卷。对于日本没有接受医学思想革命的洗礼，知情同意没有制度化的情况，我认为借鉴美国在医学思想革命发展过程中的理论努力，可以得到很大的收获。根据本研究的结果，我可以明确以下几点。(1)对先进的医疗技术所带来的问题出现了许多争论，从而发展了哲学、神学、法学、社会学和医学等学科的交叉研究。(2)其中，医学社会学在批判生命伦理学的个人主义偏见和生命伦理学自决权利的绝对化方面发挥了非常重要的作用。在这些结果的基础上，我将提出通过实地调研来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,