新自由主义全球化对“医疗化”的形构

摘要/Abstract

摘要： “医疗化”与新自由主义全球化之间有怎样的关联?国内外社会学界对此尚缺乏系统的分析。本文以物质力量、制度、观念为分析框架，探讨新自由主义如何加剧并转变全球的“医疗化”状况。在物质上，产、官、学复合体网络的多方利益形成有力的市场力量，从而促成医疗化；在制度上，则是由于药品之国际专利权的制定与各国导致医疗化的政策；在观念上，某些压力团体因为要强化“竞争力”而推动某种服药的观念、个人自主健康管理的盛行、风险恐慌的论述普遍化及另类医疗的兴起等氛围都加剧了“医疗化”。即便有反新自由主义的力量，但医疗的供给面与需求面均被牵涉到因商品化可获利的普遍利益中，因而新自由主义的结构性力量仍难以撼动，从而使医疗化加剧。

关键词: 物质力量 , 新自由主义 , 观念, 医疗化 , 制度

Abstract: There has been a lack of systematic analysis of the relation between “medicalization” and the neoliberal globalization. Drawing upon Cox’s hegemony theory, this paper intends to fill parts of this gap and suggests that Neoliberalism intensifies “medicalization” through the aspects of material power, institutions, and conception. The paper recounts on the mechanisms within these three domains respectively. In terms of material power, a complex network formed among industry, government, and academic circle can maneuver a strong market power to intensify “medicalization”. Affecting institutions include the construction of an international patent system and the policies about medicalization made by governments. As for the aspect of conception, this paper examines the promotion strategies of certain medicine by some groups having recourse to a “competitive discourse”, the popularity of selfhealthcontrol management, the spread of risk discourse and the emergence of alternative medication. However, this operation has also developed other possibilities. First of all, this operation cannot be easily achieved as the antineoliberalist forces are resisting medicalization. Secondly, new forms of medicalization have emerged which shift from the control of the health care system to a situation in which people are more willing to seek medical treatment, as a result of the popularity of health risk discourse. Also, the development of new medical technology on the one hand stops certain aspects of medicalization, but increasingly monitors human body on the other. However, despite the existence of anti neoliberalist forces, the medical supply side and the demand side are both involved in a common interest of commercialization. The structural power of neoliberalism is still difficult to shake, which ends up in the further intensification of medicalization.

Key words: Neoliberalism , institution , conception, material power , medicalization

萧易忻. 新自由主义全球化对“医疗化”的形构[J]. 社会杂志, 2014, 34(6): 165-195.

Hsiao I-Hsin. Neo-liberalist Globalization on the Formation of “Medicalization”[J]. Chinese Journal of Sociology, 2014, 34(6): 165-195.

参考文献

鲍磊. 2010. 当代日常生活的医学化［J］.前沿(11):125-127.
陈美霞.1998.期待更多有关医学中心“体制外”的研究［J］.中华卫志17(2):77-79.
韩俊红.2011.解读彼得·康拉德“社会的医学化”［J］.社会学研究(3):1-15.
林彩瑜.2004.WTO TRIPS 协议下医药专利与公共健康之问题及其解决方向［J］.政大法学评论(78) :267-342.
刘仲翔. 2010.试论农民生活的医学化［J］.江海学刊(3):135-141.
王佳煌.2007.生技资本主义:马克思主义观点的批判［J］. 科技,医疗与社会(4):16-64.
许甘霖.2009.专家知识与医疗市场［G］// 杨倍昌,编.资本主义与当代医疗.台北：巨流出版社.
杨锃. 2014.“反精神医学”的谱系：精神卫生公共性的历史及其启示［J］. 社会34(2):60-93.
张婷华、黄文鸿.2006.世界贸易组织与公共卫生之相关性［G］//全球化与公共卫生.黄文鸿、江素慧,编.台北：巨流出版社.
Abraham, John and Lewis Graham. 2002. “Citizenship, Medical Expertise and the Capitalist Regulatory State in Europe.” Sociology 36(1):67-88.
Bowring, Finn. 2003. “Manufacturing Scarcity: Food Biotechnology and the Life Sciences Industry.” Capital & Class 79:125-127.
Conrad, P. and Schneider, J. 1985. Deviance and Medicalization: From Badness to Illness. Columbus: Merrill Publishing Company.
Conrad, Peter. 2007. The Medicalization of Society : On the Transformation of Human Conditions into Treatable Disorders. Baltimore, MD: Johns Hopkins University Press.
Cox, Robert. 1987. Production, Power, and World Order: Social Forces in the Making of History. New York: Columbia University Press.
Ehrenreich, B. and J. Ehrenreich. 1974,“Health Care and Social Control.” Social Policy 15（1）: 26-40.
Esping-Andersen, Gosta. 1990. The Three Worlds of Welfare Capitalism. Oxford: Blackwell Press
Fishman, Jennifer R. 2004. “Manufacturing Desire: The Commodification of Female Sexual Dysfunction.” Social Studies of Science 34(2):187-218.
Freidson, E. 1970. Profession of Medicine. New York: Dodd, Mead
Gilbert D, T. Walley and New, B. 2000. “Lifestyle Medicines.”British Medical Journal 321:1341-1344.
Gramsci,Antonio. 1971. Selections from the Prison Notebooks. New York: International Publisher.
Harvey, D. 1990.The Condition of Postmodernity: An Inquiry into the Origins of Cultural Change. Cambridge, MA: Blackwell.
Illich, Ivan. 1975. Medical Nemesis: The Exploration of Health. New York: Pantheon Books.
Jessop,B. 2002. The Future of the Capitalist State. London: Polity Press
LaFranchi, Howard. 1997. “Amazon Indians Ask‘Biopirates’ to Pay for RainForest Riches.” Christian Science Monitor 89(249): November 20.
McKevitt, Christopher and Myfanwy Morgan. 1997. “Anomalous Patients: The Experiences of Doctors with an Illness.” Sociology of Health & Illness 19(5): 644-667.
McKinlay, J. B. 1984. “Introduction.” In Issues in the Political Economy of Health Care, edited by J. B. McKinlay. New York: Tavistock Publications.
McKinlay,J. B. 1979. “A Case for Refocussing Upstream: the Political Economy of Illness.” In Patient, Physicians, and Illness: A Sourcebook in Behavioral Science and Health ［3rd ］, edited by. Jaco, E. New York: Free Press.
Moynihan, Ray. 2003. “The Making of a Disease: Female Sexual Dysfunction.” British Medical Journal 326 (4 January): 45-47.
Mulvany, J. 2001.“Disability, Impairment or Illness? The Relevance of the Social Model of Disability to the Study of Mental Disorder.” In Rethinking the Sociology of Mental Health, edited by J. Busfield. Oxford: Blackwell.
Polanyi，K. 1994. The Great Transformation: The Political and Economic Origins of Our. New York: Rinehart and Company
Rajan, Kaushik Sunder. 2007.“Biocapital: Experimental Values.” New Left Review 45: 67-88.
Smith, D.D. 2006.“The Context of Special Education: A Time of Opportunity.” In Introduction to Special Education: Teaching in an Age of Opportunity (IDEA 2004 Upsate Edition)(5th ed.). Boston: Allyn and Bacon:2-37
Veale, B. and R. Douglas. 1992. Money Matters in General Practice. Canberra: National Centre for Epidemiology and Public Health.
Wainwright, David.2008.A Sociology of Health. London: Sage.
Zola, Irving. 1972 . “Medicine as an Institution of Social Control .”The Sociological Review 20(4):487-504.

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