摘要
Abstract
Technology decisions are typically characterized by reliance on a large number of complex and sophisticated scientific and technical expertise,and by the fact that they often have an impact on broader social groups.These two features pose a difficult problem for technical decision-making:When experts and the public disagree on judgment,who should make the decision?Technocrats argue that decisions should be made by experts for two main reasons.One is that scientific and technological knowledge is objective.The other is the belief that power derives its legitimacy from superior knowledge and skill(rather than general will);The democratic model holds that citizens should decide,for the following reasons:First,the will of citizens is the source of legitimacy of public decisions.Second,the process of scientific research has included the balance of political power,infiltrating the value and interest bias of scientists.Technocracy creates the problem of too much power for experts,while the democratic model devalues the role of experts,leading to technopopulism.
The expertise theory proposed by Collins and others holds that expertise should be relied on to solve the problem of demarcation of the scope of participation.Expertise is more common than scientific and technical knowledge.On the one hand,the public can have expertise based on experience.Another aspect is that expertise in science is different from other expertise.Science is of special value to society and therefore occupies a special place in democracy.The expertise theory divides technical decision-making into technical and political stages.In the political stage,every citizen has the right to participate,and the reason for participating is that the outcome of the decision is related to the interests of the participants.At the technical stage,people with expertise related to the area of technical decision making can participate,and the reasons for participating are based on the relevant expertise or experience.
According to Collins,the function of the technical stage is the combination of expertise.But he has no more to say about how the different kinds of expertise combine.Indeed,doctor-patient shared decision-making can provide a concrete example of combination.A doctor is usually regarded as a person with expertise.But research in medical sociology in recent years has shown that patients also have many experience-based expertise.A patient's expertise is often gained through experience with his or her own body,illness,and lifestyle.The patient's expertise is mainly reflected in his understanding of the disease from a specific life perspective,including their body and pain,response to drugs,personal experience of their working and living environment,and especially their own preferences and values for diagnosis and treatment.The combination of expertise between doctors and patients is not only a separate investigation by doctors and patients based on their own information and the information provided by the other,but a collaborative investigation.Each side has to influence,modify,and refine the other's point of view.In process of combination of expertise,the management of doctor-patient disagreement is very important.There are many causes for the doctor-patient disagreement.Patient misunderstandings often stem from a lack of understanding of the characteristics and basic methods of medical practice.The doctor's misunderstanding comes from a lack of understanding of the patient's psychological state,and a lack of understanding of the patient's way of interpreting information.These practices of doctor-patient shared decision making provide enlightenment on how to understand the characteristics of expertisecombination in general technical decision making.关键词
专长/技术民主/专长联合/医患共同决策Key words
expertise/technological democracy/expertise combination/shared decision making分类
社会科学
