| Abstract: | 本論文研究的目的是希望以明代的醫病關係為線索觀察明代的醫德觀。道德觀念的建立並非脫離特定的時空環境。由於明代醫者的行醫環境充斥著不安定因素，皆會影響醫者的行為，也連帶衝擊到道德觀的形成。由於明代醫者地位不高加上國家對活躍於民間廣大的醫者們，卻不見有一標準化的考核過程及認證的作法，為明代醫者無法建立權威性與民眾的信任感的主要原因。而醫者素質良又不齊對醫療市場與民眾信任感所產生的衝擊。
病人為求自保會產生屢試醫、頻更醫、巫醫並用、孝子學醫等行為，這些行為會影響醫生的自我認知及價值。有人是先說同業者的壞話，誇耀自己醫術如何高明。用很誇張的言詞相病人恐嚇說他之前找錯醫生，讓病人心情起伏慌亂。也有些人會努力充實自己的醫學術養，期許自己醫術高明，救人無數。明代醫者透過醫理的闡發與醫案的撰作等方式，嚴謹看待醫學知識，是對醫學本身的重視，也是在「醫病關係」中爭取發言權的努力。明代醫者還透過對於藥物品質的堅持，表現對病人的負責態度。而由於法律無法還這一些因庸醫而死的人一個公道，自然當時人的心態就轉向由上天來為他們討回一些該屬於他們的公平與正義。在明代醫籍中，這種「冥報觀」屢見不鮮，也是明代醫德觀念中相當有趣的現象。
Purpose of this dessertation is to observe medical ethics in Ming Dynasty through relation between practitioner and patient during that period. The concept of ethics or moral is always without a base, it must be restricted to certain time and space. Due to some uncertainties in the environment of practitioners during Ming Dynasty,it had affected practitioners behaviour and contributed to the shaping of ethical thoughts. The status of practitioners during Ming period was low, governemnt did notimpose any standardized prosedure or examination on practitioners who serve majority of the people. Those were the reasons why practitioners during Ming could not build up authority and failed to gain trust from the mass.
Unguaranteed medical quality offered by practitioners of different background and standard further deteriorated the market and increase distrust. Patients would try whatever they could to survive, including changing practitioners quite often, seeking medical services on trial and error basis, seeking shamantic ways of curing disease, inccidents like son learnt medical to give parents treatment did happens as well. These behaviours and acts all contributed to the self-perception and value of practitioners. Some of them portrayed themselves by condeming others, convinced the patients that they seek the wrong practitioners, persuading them to look for another practitioner which caused patients to panic. On the other hand, some practitioner would make self-improvement, hoping oneself to save lots of lives. Generally, practitioners attitudes towards medical knowledge during Ming Dynasty were quite serious. They explored new medical theory, investigated cases, applying new techniques; all these reflected their concerns, and these efforts also help them to obtain the rights of expression in relation between practitioners and patients. Practitioners in Ming Dynasty show their responsibility to patients by insisting the quality of medicines. Since patients who were victimized by some irresposible practitioners could not claim justice via legal prosedure, most of them turn to(Shang Tian)- the Sky , for equal and justice. These types of concept was commonly found in medical text during Ming Dynasty, and its an interesting phenomenon in medical ethics during that period. |
