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5.醫療場域中專業協作的順從與反抗:呼吸治療的建制民族誌(Compliance and Resistance in Professional Medical Practices: An Institu
2018-08-20
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中文摘要
為改善呼吸器依賴患者佔用急性病房或加護病房的問題,以有效利 用急性醫療之資源,解決加護病床急症患者一床難求的窘境,當時之行 政院衛生署提出不同計畫來對不同病程提供分段照護措施,期待在健保 的給付架構下,能有效率和合理分配醫療照護資源。然而,從呼吸治療 個管師在建制體系內的醫療實作發現,病患最佳利益與相關建制系統間 卻因此產生許多利益衝突的現象。本文擬透過建制民族誌,探索在呼吸 治療照護的實作中,反映出醫療體制何種多元面貌的統治關係,並試圖 指出相關的醫療協作如何產生階級差異化的再製。論文最後也將檢討方 法論,指出建制民族誌可能的研究限制。
關鍵詞:呼吸器、呼吸治療師、建制民族誌、階級、醫療倫理
形式 Form 文字、單期
來源 Origin 台灣社會學會
關聯 Relation 台灣社會學刊第61期
英文摘要 abstract Compliance and Resistance in Professional Medical Practices: An Institutional Ethnography of Respiratory Therapy Li-Chen CHANG Clinical Medical Research Center Ditmanson Medical Foundation Chiayi Christian Hospital Ming-Hua HUANG Department of Respiratory Therapy Room Ditmanson Medical Foundation Chiayi Christian Hospital Wei-Hsian CHI Institute of Sociology, Academia Sinica Abstract Taiwan’s Ministry of Health has implemented new policies regarding respiratory therapy for different illness stages in order to optimize efficiency in providing health care and increase the availability of ICU beds. Drawing upon participant observations and in-depth interviews, this article reveals otherwise obscured conflicts of interest between patient benefits and organizational demands in the professional practices of respiratory therapists. Specifically, from an institutional ethnography (IE) analysis, this article illuminates multiple dimensions of “ruling relations” in institutionalized respiratory therapy resulting in making and maintaining class inequalities for the socially disadvantaged. In critical dialogue with IE, this article concludes with methodological reflections and limitations in doing institutional ethnography.
Keywords: Respirator, Respiratory Therapist, Institutional Ethnography, Class, Medical Ethics
創作者 Creator 張麗珍、黃明華、齊偉先(Li-Chen CHANG, Ming-Hua HUANG, Wei-Hsian CHI)
出版者 Publisher 台灣社會學會
貢獻者 Contributor  
權利 Right 已授權
日期 Date 2017年06月
格式 Format pdf
識別碼 Code tsa-tj-061_20170600_0004-0000-p
語言 Language 中文
數位檔連結Download ( tsa-tj-061_20170600_0004-0000-p.pdf )
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