医療問題研究の社会科学的基礎

-主にわが国の医療供給に関する諸問題-

抄録

In this special issue on “Medical Sociology”, the author attempts to discuss the social scientific foundation and standpoint, in order to test the validity of so called “Medical Sociology” and, if possible, seek possible ways of development in this discipline in question.
The author's discussion starts with the fundamental recognition that health care services are composed of labour, or labour processes. He, therefore, analyses labour and labour processes in health care services using such key concepts as three elements of labour (subject=health care worker, object=patient, and means of labour=medical tools, appliances and machines), two processes of labour (technological and organisational processes), and two factors of labour (which lead to the health care delivery system and the economic system of health care services). In addition to these fuudamental concepts, the historical background of development in capitalism (at least in Japan) is indispensable as an important social scientific standpoint.
According to the above fundamental concepts and scientific standpoint, different phenomena and problems in the following sectors of health care services are discussed : (1) medical technology, (2) people's health and diseases, (3) health care delivery system, (4) health economy, (5) education for health care workers, (6) industries relating to health case services, etc. The strong dependency on private practice is a key factor to explain different traditional and contemporary problems in health care services in Japan. A new big trend in this area is the influence or invasion of monopoly capital by the pharmaceutical, computer and other medical engineering industries in support of.the government's policies, which is a typical phenomenon at the stage of state-monopoly capitalism.
The author stresses that the sociologist, or the medical sociologist, should test the validity and look for new ways of “Medical Sociology” according to the above concepts, standpoint and discussions.