Becker G, Nachtigall R D
Department of Social and Behavioural Sciences, School of Nursing, University of California, San Francisco 94143-0612.
Soc Sci Med. 1994 Aug;39(4):507-18. doi: 10.1016/0277-9536(94)90093-0.
As American society has become increasingly medicalized, biomedically shaped constructions of risk have begun to dominate traditional cultural constructions. This paper examines how the quest for a pregnancy affects the construction of risk by women in infertility treatment in the United States. Findings are based on a longitudinal, qualitative study with 275 persons (132 couples and 11 women) who experienced infertility. Because women's involvement in medical treatment was greater than that of men and because they were more intent on treatment, women assumed the role of final arbiter of what was a risk, and which risks to take. Women perceived more risks than men and were more willing to take risks than men. Notions of risk changed for both women and men, however, as they proceeded through medical treatment. This research suggests that once infertility is medically designated as a disease, both patients and practitioners pursue a 'cure' through a well-delineated pattern of medical treatment, despite the risks of such treatment and independent of the likelihood of success. When medical views of risk and responsibility are teamed with women's persistence in the pursuit of a pregnancy, medical treatment may be taken to extremes. Americans consider risk-taking to be their prerogative when personal histories reflect strong cultural mandates about norms, values, rights, and responsibilities, and these in turn are interpreted as health-related by both consumers and health professionals. As a consequence, the forces that trigger medicalization are activated and medical technology is given potentially limitless scope.
随着美国社会日益医学化,由生物医学塑造的风险观念已开始主导传统文化观念。本文探讨了在美国,求孕过程如何影响接受不孕治疗的女性对风险的认知。研究结果基于一项对275名经历不孕的人(132对夫妇和11名女性)进行的纵向定性研究。由于女性参与医疗治疗的程度高于男性,且她们更渴望接受治疗,所以女性承担了最终裁定何为风险以及应承担哪些风险的角色。女性比男性察觉到更多风险,也比男性更愿意冒险。然而,随着治疗的推进,女性和男性对风险的认知都发生了变化。这项研究表明,一旦不孕在医学上被认定为一种疾病,患者和从业者都会通过明确的治疗模式来寻求“治愈”,尽管这种治疗存在风险且与成功的可能性无关。当风险和责任的医学观念与女性对怀孕的执着相结合时,医疗治疗可能会走向极端。当个人经历反映出关于规范、价值观、权利和责任的强烈文化要求,而这些又被消费者和健康专业人员都解读为与健康相关时,美国人认为冒险是他们的特权。因此,引发医学化的力量被激活,医疗技术被赋予了潜在的无限空间。