Dolgin, Janet L. 2014. Neither Father nor Doctor “Knows Best”: From Tradition to Choice in the Family and on the Wards. Journal of Family Theory & Review 6: 62-75.
This article aims to present the shifts in the meaning of family with an analysis about he changing family relationship and the relationship within theworld of health care. First, the author use courts and related family laws in 1960s and 1970s to present that the portrait of family has transformed from a hierarchically structured community to a collection of autonomous individuals. Then,three developments in the world of health care are demonstrated regarding the concomitant changes in family and the form of family relationship. The three examples are construction and elaboration of the informed-consent doctrine in clinical settings, new reproductive technology and the birth of “new” families, and genetic testing and “familial” conditions. Informed-consent was implemented in late 1970s with an acknowledgement of the autonomous individuality of patents but also an assumption of a capable patient.A more recent concern with limiting patient autonomy to safeguard a patient’s welfare suggests an effort to mediate the demands of individualism with those of community. Each new reproductive technology raises questions about the best way to determine legal parentage and the role biology plays in defining family. Finally, the genetic testing puts clinics at stake in determining whether a patient should be considered as an individual or a group of people joined by putative genetic similarities. The author selects a lot of court cases to call attention from family researchers and clinicians on the changing meaning of parenthood and relationship.
这篇文章介绍了几十年来家庭意义和家庭关系的变化，以及这些变化在医疗健康领域所带来的影响。首先，作者根据二十世纪六七十年代的案例和家庭法的分析，发现家庭的概念已经从一个有等级制度的结构社区转变为一个具有自主性的个体组合。接着，作者分析了三个医学领域的变化：第一、知情同意制度的推广；第二、新的生殖技术以及由此产生的“新”的家庭；第三、基因检测以及由此涉及到的个人/家庭边界。知情同意制度的推行使病人也成为治疗过程中的一个参与者，但是，这个制度前提假设了有完全决策力的个人，而忽略了很多情况下，病人并没有决策力；接着，新的生殖技术挑战了传统的家长概念，也模糊了生物学在决定家庭边界的作用；最后，基因技术的逐步推行医生在很多时候不知道是否有义务通知病人家属，使他们可以早点预防可能发生的疾病。总而言之，作者选取了非常详实的案例资料进行分析，并且呼吁家庭研究者和医生关注到不断发生变化的家长和家庭关系的概念。