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医学化与认知不公。

Medicalization and epistemic injustice.

作者信息

Wardrope Alistair

机构信息

The Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK,

出版信息

Med Health Care Philos. 2015 Aug;18(3):341-52. doi: 10.1007/s11019-014-9608-3.

Abstract

Many critics of medicalization (the process by which phenomena become candidates for medical definition, explanation and treatment) express concern that the process privileges individualised, biologically grounded interpretations of medicalized phenomena, inhibiting understanding and communication of aspects of those phenomena that are less relevant to their biomedical modelling. I suggest that this line of critique views medicalization as a hermeneutical injustice--a form of epistemic injustice that prevents people having the hermeneutical resources available to interpret and communicate significant areas of their experience. Interpreting the critiques in this fashion shows they frequently fail because they: neglect the ways in which medicalization may not obscure, but rather illuminate, individuals' experiences; and neglect the testimony of those experiencing first-hand medicalized problems, thus may be guilty of perpetrating testimonial injustice. However, I suggest that such arguments are valuable insofar as they highlight the unwarranted epistemic privilege frequently afforded to medical institutions and medicalized models of phenomena, and a consequent need for greater epistemic humility on the part of health workers and researchers.

摘要

许多对医学化(即现象成为医学定义、解释和治疗对象的过程)持批评态度的人担心,这一过程使对医学化现象的个体化、基于生物学的解释享有特权,抑制了对这些现象中与生物医学模型不太相关的方面的理解和交流。我认为,这种批评思路将医学化视为一种诠释学上的不公正——一种认知不公正的形式,它使人们无法获得诠释学资源来解释和交流其经历中的重要领域。以这种方式解读这些批评表明,它们常常失败,原因在于:忽视了医学化可能并非掩盖而是阐明个人经历的方式;忽视了那些亲身经历医学化问题者的证词,因此可能犯有证言不公正的过错。然而,我认为这些论点是有价值的,因为它们凸显了医疗机构和医学化现象模型常常被赋予的不合理的认知特权,以及医护人员和研究人员因此需要具备更强的认知谦逊态度。

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