Medicine and the Management of Living: Taming the Last Great Beast
Medicine and the Management of Living: Taming the Last Great Beast
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医学与生活管理：驯服最后的野兽
DOI：
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发表时间：
1986
期刊：
影响因子：
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通讯作者：
B. J. Bergen
中科院分区：
文献类型：
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作者：
W. Arney;B. J. Bergen
近年来，美国医患关系发生了巨大变化。自然分娩、重病患者支援团体、健康维护组织、家人朋友间“安乐死”的临终关怀，都在逐渐被接受，这是医疗实践重新定义、医疗权力领域重新定义的一部分。医疗实践不再局限于“驯服死亡野兽”和与人体内可观察到的疾病作斗争。现代医生现在是一个生活的管理者，把病人看作是一个关系网络中的“完整的人”。《医学与生活管理》质疑病人如何从一个在诊所被观察到的沉默标本转变为一个对医疗实践和话语具有重要意义的主观疾病体验的人。Arney和卑尔根问道，是什么激发了医学需要考虑整个人，包括病人对他或她的疾病的表现？病人是用什么样的方式来谈论自己的呢？作者认为，自20世纪50年代以来，在医学话语中纳入患者的经验与其说是“患者反叛”的结果，不如说是医疗机构本身沉淀的活动。阿尼和卑尔根从米歇尔·福柯的著作中汲取灵感，研究了医疗权力的结构，认为支持团体等新的社会技术使患者的主观性可用于医疗评估、判断和操纵。在这篇敏感的书面讨论中，作者从许多来源摘录了他们提出的问题-一位死于癌症的诗人的作品，医生思考自己致命疾病的评论，以及流行杂志，医学期刊和社会学研究的摘录。他们通过历史来审视医学界不断变化的角色，使用现代广告形象和维萨里文艺复兴时期解剖学文本中的木刻来展示健康和医学的象征性写照。他们广泛的关注引导读者通过这样的主题，如少女怀孕;历史治疗的医学异常，如两性和“象人”（约翰梅里克）;和文学代表性的疾病在莎士比亚，契诃夫，和布赖恩克拉克最近的百老汇戏剧，“谁的生活是它反正？《医学与生活管理》以一种挑衅而又深思熟虑的方式，为彻底重新评估医疗力量和医疗机构指明了道路。"
In recent years, relations between patients and physicians in America have undergone a dramatic change. The growing acceptance of natural childbirth, support groups for patients with serious illnesses, health maintenance organizations, and hospices for a "happy death" among family and friends is part of a redefinition of medical practice and reformulation of the field of medical power. No longer is medical practice confined to "taming the beast" of death and fighting the diseases observable in the human body. The modern practitioner is now a manager of the living, taking an ecological view of the patient as a "whole person" in a network of relationships. "Medicine and the Management of Living" questions how it has been possible for the patient to change from a silenced specimen observed in the clinic to a person whose subjective experience of illness is important to medical practice and discourse. Arney and Bergen ask, What incited the demand that medicine take the whole person, including the patient's presentation of his or her illness, into consideration? And in whose terms are patients speaking about themselves? The authors argue that the inclusion of patients' experiences in medical discourse that has come about since the 1950s is not so much a result of a "patient rebellion" as an activity preciptated by the medical establishment itself. Drawing inspiration from the work of Michel Foucault, Arney and Bergen examine the structure of medical power, contending that new social technologies like support groups make the patient's subjectivity available for medical evaluation, judgment, and manipulation. Throughout this sensitively written discussion, the authors vivify the issues they raise with excerpts from many sources the writings of a poet dying of cancer, the comments of doctors pondering their own fatal illnesses, and excerpts from popular magazines, medical journals, and sociological studies. They examine the changing role of the medical profession through history, using a modern advertising image and woodcuts from Vesalius's Renaissance anatomy text to show the symbolic portrayal of health and medicine. Their wide-ranging concerns lead the reader through such topics as teenage pregnancy; the historical treatment of medical anomalies like hermaphrodites and the "elephant man" (John Merrick); and literary representations of illness in Sartre, Chekhov, and Brian Clark's recent Broadway drama, "Whose Life Is It Anyway?" In a provocative yet thoughtful way, "Medicine and the Management of Living" points the way for a radical reassessment of medical power and the medical establishment."