"年老" 身份类属在医患沟通中的作用 = Using "oldness" as an interactional resource in doctor-patient interaction

• Main Author: 林鼎勋 Lim, Ding Xun
• Other Authors: Lim Ni Eng
• Format: Thesis-Master by Research
• Language: Chinese
• Published: Nanyang Technological University 2022
• Subjects: Humanities::Language::Chinese
• Online Access: https://hdl.handle.net/10356/162536
• Institution: Nanyang Technological University

会话分析作为互动语言学的基础在汉语言学界已不是陌生的语用学领域。然而，与之在民俗方法学框架下同根同源的身份类属机制却鲜为人知（Psathas, 1980）。本文重点介绍身份类属机制如何成为话语的显著诠释机制，为互动交际建构至关重要的交互主体性。以新加坡某一家医院里的门诊语料为例，我们结合会话分析方法探讨“年老”这一身份类属在门诊互动中的作用。研究显示，标识“年老”身份不仅能被医生列为合理化患者病症的依据，也能作为建议患者进行医疗检查的理由；另一方面，华族年长患者也同样会标榜自己“年老”的身份，作为合理化自己病症的依据、拒绝医疗建议以及辩解身体功能缺失的理由。这几种对“年老”身份类属的解读看似矛盾，实则反映了身份类属机制中的重要运作原理，即同一身份类属下可能折射出不同，却一样合理的常识性推论。通过分析门诊会话中“年老”身份类属的使用，本文论述了身份类属机制这一会话互动资源的价值。Conversation Analysis (CA) as the foundation of Interactional Linguistics (IL) is already a well-known discipline in the studies of Chinese linguistics. However, the communicative apparatus known as Membership Categorization Device (MCD), which is also based in Ethnomethodology (Psathas, 1980) is still unfamiliar to most. In this article, we describe how MCD works as a common interpretive mechanism in interactional practice, which is key to constructing the intersubjectivity of interlocutors. To illustrate how MCD works, we focused on the category of “oldness”, and analyze its usage based on video- recordings of authentic medical consultations from a Singapore hospital. Our findings show that “oldness” as a MCD can be used by doctors as justification for medical recommendations and to normalise patients’ illnesses, but can also be used by elderly Chinese patients to reject doctors’ recommendations, to normalise their own illnesses and to justify their physical disabilities. While such interpretation of “oldness” may seem contradictory, it in fact instantiates an important principle in the operational apparatus of MCD. That is, the same MCD can facilitate different but equally valid trajectories of what Ethnomethodology terms “common-sense reasoning” as an interpretive mechanism. Through detailed CA analysis of the “oldness” MCD in medical interactions, we highlight the value of MCD as an important interactional resource.