Waitzkin H
Int J Health Serv. 1984;14(3):339-78. doi: 10.2190/UQQX-435T-XV3T-5A3Q.
Certain features of the doctor-patient encounter "medicalize," and thereby depoliticize, the social structural roots of personal suffering. The critique of medicalization holds that medicine has become an institution of social control, that the health care system helps promulgate the dominant ideologies of a society, and that the doctor-patient relationship is a major site where these developments occur. This paper presents a contextual analysis of medical encounters, drawn from a sample of tape-recorded doctor-patient interaction in medical practice. The doctor-patient relationship manifests problems that arise despite the best conscious intents of well-motivated participants. Conveying the symbolism of scientific medicine, messages of ideology and social control reinforce current relations of economic production and reproduction in work, the family, leisure, pleasure, sexuality, and other areas of social life. Ambiguities within the doctor-patient relationship both reflect and help reproduce broader social contradictions and structures of oppression. The medical encounter is one arena where the dominant ideologies of a society are reinforced and where individuals' acquiescence is sought. A vision of a progressive doctor-patient relationship must include a conception of how that relationship contributes to fundamental social change.
医患互动的某些特征会将个人痛苦的社会结构根源“医学化”，进而使其去政治化。医学化批判认为，医学已成为一种社会控制机构，医疗保健系统有助于传播社会的主流意识形态，且医患关系是这些发展得以发生的主要场所。本文对医疗互动进行了情境分析，该分析取材于医疗实践中录制的医患互动样本。尽管参与互动的各方动机良好且意图真诚，但医患关系仍暴露出一些问题。科学医学的象征意义、意识形态和社会控制信息强化了当前工作、家庭、休闲、娱乐、性及其他社会生活领域中的经济生产与再生产关系。医患关系中的模糊性既反映了更广泛的社会矛盾和压迫结构，又有助于这些矛盾和结构的再生产。医疗互动是强化社会主流意识形态并寻求个体默许的一个领域。一种进步的医患关系愿景必须包含对该关系如何促成根本性社会变革的构想。
