【作者简介】梅 笑，刘天琦，复旦大学社会发展与公共政策学院

【文章来源】《社会学评论》2025年第4期

【内容提要】患者依从性一直被认为是医疗技术取得预期疗效的关键因素，是医疗社会学领域的重要研究议题。对于患者的低依从性，既有研究从多个角度进行解释，但依然无法为提高患者依从性提供有效的理论指导。本文首先辨析了依从性概念背后的理论和价值预设，指出现有关于患者依从性的讨论存在悖论，应当用物质主义的实践理论视角替代以人为中心的权力关系视角，将理解患者依从性的关键从医患关系转化为患者认为的更好的选择是如何形成的；其次从文化社会学的角度揭示了医疗技术作为文化之物如何塑造患者认为的更好的选择，认为应把医疗技术的物质性、象征性与人的认知、身体联系起来，探讨包括医疗技术在内的多元行动者是如何互动并对患者依从性产生影响的。本研究对于如何在医患取得共识的情况下推动医疗实践、减轻患者痛苦具有理论启示。

【关键词】医疗技术 / 患者依从性 / 文化之物 / 实践理论

【全文链接】http://src.ruc.edu.cn/CN/Y2025/V13/I4/27

Medical Technologies as Cultural Objects:A Sociological Review on Patient Compliance

Abstract: Patient compliance has always been considered a critical factor affecting the outcome of medical practice, and therefore, it attracts much attention from medical sociologists. Past research offers various explanations for why patients cannot always comply with medical instructions. This article first reviews the theoretical underpinnings of the value-laden concept of patient compliance, and points out the discrepancies between theory and practice in the scholarly discussion. Secondly, this article argues that we should understand compliance as objectoriented practice instead of the result of intersubjective power relations. That is, we should not treat patient compliance simply as manifestation of doctor-patient relationships, but understand it as“better”choices made by the patients when interacting with medical technologies. Furthermore, this article proposes to bring cultural sociology into the discussion to demostrate how medical technologies, as cultural objects, construct the“better”choices of the patients, emphasizing how both the materiality and symbolic aspects of the medical technologies, by interacting with both the bodily and cognitive capacities of humans, ultimately shape patient compliance. This article hopes to shed some theoretical light on how to push forward medical practices and reduce the suffering of the patients.