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权力、矫正与规训阴影下的关怀潜能——基于米歇尔·福柯著作的法医精神病护理

Caring potentials in the shadows of power, correction, and discipline - Forensic psychiatric care in the light of the work of Michel Foucault.

作者信息

Hörberg Ulrica, Dahlberg Karin

机构信息

Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden;

Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.

出版信息

Int J Qual Stud Health Well-being. 2015 Aug 27;10:28703. doi: 10.3402/qhw.v10.28703. eCollection 2015.

Abstract

The aim of this article is to shed light on contemporary forensic psychiatric care through a philosophical examination of the empirical results from two lifeworld phenomenological studies from the perspective of patients and carers, by using the French philosopher Michel Foucault's historical-philosophical work. Both empirical studies were conducted in a forensic psychiatric setting. The essential results of the two empirical studies were reexamined in a phenomenological meaning analysis to form a new general structure in accordance with the methodological principles of Reflective Lifeworld Research. This general structure shows how the caring on the forensic psychiatric wards appears to be contradictory, in that it is characterized by an unreflective (non-)caring attitude and contributes to an inconsistent and insecure existence. The caring appears to have a corrective approach and thus lacks a clear caring structure, a basic caring approach that patients in forensic psychiatric services have a great need of. To gain a greater understanding of forensic psychiatric caring, the new empirical results were further examined in the light of Foucault's historical-philosophical work. The philosophical examination is presented in terms of the three meaning constituents: Caring as correction and discipline, The existence of power, and Structures and culture in care. The philosophical examination illustrates new meaning nuances of the corrective and disciplinary nature of forensic psychiatric care, its power, and how this is materialized in caring, and what this does to the patients. The examination reveals embedded difficulties in forensic psychiatric care and highlights a need to revisit the aim of such care.

摘要

本文旨在通过运用法国哲学家米歇尔·福柯的历史哲学著作,从患者和护理人员的角度对两项生活世界现象学研究的实证结果进行哲学审视,从而阐明当代法医精神病护理的情况。这两项实证研究均在法医精神病学环境中进行。在现象学意义分析中重新审视了这两项实证研究的基本结果,以根据反思性生活世界研究的方法论原则形成一个新的总体结构。这个总体结构表明,法医精神病病房的护理似乎是自相矛盾的,因为它的特点是一种未经反思的(非)护理态度,导致了一种不一致和不安全的生存状态。这种护理似乎采取了一种矫正方法,因此缺乏明确的护理结构,而法医精神病服务中的患者非常需要一种基本的护理方法。为了更深入地理解法医精神病护理,根据福柯的历史哲学著作对新的实证结果进行了进一步研究。哲学审视从三个意义构成要素展开:作为矫正与规训的护理、权力的存在以及护理中的结构与文化。哲学审视揭示了法医精神病护理中隐含的困难,并强调需要重新审视这种护理的目标。

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