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“生活方式、有限性还是不平等?”:凯瑟琳·康威和亚瑟·弗兰克癌症回忆录中的疾病阐释。

"Lifestyle, finitude, or inequality?": Illness explanation in Kathlyn Conway's and Arthur Frank's cancer memoirs.

机构信息

National Dong Hwa University.

出版信息

Health (London). 2022 Sep;26(5):663-678. doi: 10.1177/13634593211054009. Epub 2021 Oct 22.

DOI:10.1177/13634593211054009
PMID:34674571
Abstract

The lifestyle model, which attributes etiological power and moral responsibility to the individual, is dominant in health promotion discourse. While sociologists rightly critique this model's individualistic outlook, there has been insufficient distinction between the two anti-individualistic models that commonly inform their work: the well-known "sociological model" and the culturally influential but under-conceptualized model tentatively called the "finitude model." Not only is there insufficient awareness of the different etiological causes (inequality and human fragility) and political orientations (redistribution and recognition) underlying the sociological and finitude models, but there is also insufficient recognition of how the finitude model may inform illness explanation. To raise awareness about the existence and analytical utility of the finitude model, I elucidate its core assumptions through a brief review of some influential texts in late-modern health politics. Further, I illustrate the empirical utility of the notion of the finitude model by analyzing how it is used to explain illness in Arthur Frank's and Kathlyn Conway's influential cancer memoirs. Thematic analysis of the memoirs produces two major findings. First, Frank and Conway rely on the finitude model to claim victimhood and blame the blamers. Second, they seem unaware of the double-edged character of such a model, which tends to downplay how social inequality shapes health. My analysis reveals the one-sidedness of both the finitude and sociological models, and that any illness explanation therefore needs to integrate both anti-individualistic models to challenge the lifestyle model successfully.

摘要

生活方式模型将病因和道德责任归因于个体,在健康促进话语中占主导地位。尽管社会学家正确地质疑了这种模型的个人主义观点,但他们对两种常见的反个人主义模型之间的区别认识不足:著名的“社会学模型”和在文化上有影响力但概念化不足的模型,姑且称之为“有限性模型”。不仅对社会学和有限性模型所依据的不同病因(不平等和人类脆弱性)和政治取向(再分配和认可)认识不足,而且对有限性模型如何影响疾病解释也认识不足。为了提高对有限性模型的存在和分析效用的认识,我通过简要回顾现代健康政治中一些有影响力的文本,阐明了其核心假设。此外,我通过分析亚瑟·弗兰克 (Arthur Frank) 和凯瑟琳·康威 (Kathlyn Conway) 的有影响力的癌症回忆录中如何使用有限性模型来解释疾病,说明了有限性模型概念的经验效用。对回忆录的主题分析产生了两个主要发现。首先,弗兰克和康威依靠有限性模型来主张受害者身份并指责指责者。其次,他们似乎没有意识到这种模型的双刃剑特征,因为这种模型往往会淡化社会不平等如何影响健康。我的分析揭示了有限性模型和社会学模型的片面性,因此任何疾病解释都需要整合这两种反个人主义模型,才能成功挑战生活方式模型。

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