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研究生:盧秀琴
研究生(外文):Hsiu-Chin Lu
論文名稱:醫藥新聞與醫療化-以威而鋼為例
論文名稱(外文):Medicalization of Medical News:Viagra as an Example
指導教授:張玨 
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:衛生政策與管理研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:124
中文關鍵詞:醫藥新聞專業意理威而鋼醫療化
外文關鍵詞:professional ideologyViagramedicalization
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近來性功能議題在報紙電視出現頻率增加,其中治療性功能勃起障礙藥物威而鋼之大量相關報導,對男性健康、女性健康及兩性關係影響極大,性功能過去在家�婼耵漕ヾA因為威而鋼而成為公開討論的話題,因此出現批評媒體幫忙賣藥,威而鋼被當春藥濫用的聲音,不舉是不是疾病?媒體報導是否協助性功能被醫療化?

本研究目的如下:                   
一、分析威而鋼報導所呈現的概念和性功能被醫療化的關係
二、探討威而鋼報導與勃起功能障礙治療之變遷
三、分析媒體報導威而鋼治療性功能障礙之建構策略         
本研究採取質性研究的三角交叉檢視法,包括內容分析、論述分析及深度訪談三種方法。針對蒐集1998年3月1日至2003年12月31日間,民生報與聯合報關於威而鋼相關新聞報導,以記者採訪撰寫之新聞與外電報導為研究樣本,共取得570則樣本,進行文本內容和論述分析。另蒐集生產威而鋼藥廠輝瑞藥廠舉辦七場記者會提供之新聞稿內容七篇,與該新聞發佈後中國時報、聯合報、民生報呈現報導內容比較。針對兩名記者、三名藥廠公關人員、一名泌尿科醫師和一名政府官員進行深度訪談,協助了解性功能被醫療化的形成。

本研究重要發現為:
記者傳播醫師論述協助性功能醫療化,記者間接協助藥廠促銷性功能治療藥物,政府政策態度間接導致媒體報導協助性功能醫療化,醫師、藥廠、記者三者互動,協助性功能在醫藥報導中被醫療化。

在報導中呈現如下:
1、威而鋼新聞報導年代變化上以1998年5月開始大幅增加,在1998年底國內衛生署宣布威而鋼通過藥證到1999年3月22日威而鋼在台上市,是主流論述報導高峰。
2、威而鋼新聞報導內容分為兩大類:(1)、主流論述(2)、對抗論述,主流論述主要被引述者為泌尿科醫師,學術研究,對抗論述主要被引述者,則以其它科別醫師,女權團體為主。
3、主流論述內容性功能以西醫生物醫學模式來看待最多,強調需要就醫治療。性功能障礙需要治療,把性功能視為疾病,服用威而鋼需由醫師專業判斷,威而鋼是不舉男人的救星。
4、威而鋼報導的內容與轉型:(1)、威而鋼上市進度(2)、威而鋼的副作用(3)、威而鋼神奇功效(4)、威而鋼退燒和其它新藥、療法出現。(5)、男性主動角色,女性性功能受忽略。
5、對抗論述分兩類:心理社會論述模式與醫療化批判,將性功能問題歸因到心理社會原因,包括夫妻關係不佳,或是家庭有「必須添丁」等不合理期待、環境不適當等,而非只有藥物。批判性論述指出不應被西醫模式隴斷,過度強調其醫療及到醫院檢查的重要性,是對藥廠,醫界獲利,不是對民眾健康有幫助。
6、性功能障礙報導的建構策略:過去隱諱不談的性功能,因為治陽痿口服藥威而鋼出現而被公開討論,加上威而鋼是醫師處方用藥,所以報導直接將性功能是否障礙納入醫療範籌,並且強調應即早就醫治療。

7、威而鋼治療性功能的建構策略:(1)、以醫學權威研究說服,大量科學研究資料佐證,利用調查數字突顯治療重要性。(2)、威而鋼是處方用藥,必須在醫師指示下服用。(3)、政府政策與把關。(4)、民眾經驗分享:大量引用服用過威而鋼創造性福的成功案例說服。
8、對抗論述的建構策略,性功能報導建構策略:提供威而鋼以外的方法,威而鋼不是萬靈丹,必須從心理、社會層面配合,主要由精神科醫師提出,另外也有把性功能衰退視為男性更年期正常老化現象,女性團體及社會或公衛學者提出性功能不一定要治療的觀點。

9、記者新聞呈現內容皆以引述藥廠現場提供之新聞稿內容為主,只有少數記者會質疑研究的公正性,採訪對象也是以在記者會場受藥廠邀請來的泌尿科醫師、心臟科醫師,研究學者為主,並沒有尋求其它醫師的意見。

10、媒體在威而鋼與性功能相關報導,有渲染誇大現象,記者、醫師接受藥廠招待出國採訪相關研討會,只有少部份記者拒絕,雖警覺到藥廠行銷手法,卻仍難捨棄該邀約之新聞線索與新聞競爭,醫師則認為藥廠行銷是創造醫師民眾與藥廠三贏。而電視媒體常受限採訪時間壓力及收視率,無法深入探討問題,恐淪為醫師專業所利用,平面記者雖有較充裕查證時間卻還是難與醫師權威抗衡。

本研究提出四點建議:
1、記者應不斷對醫療權威提出質疑,媒體應檢討對性功能報導內容,如何不讓商業影響新聞專業。
2、目前法令規定藥物不得藉新聞報導採訪宣傳,政府對於新聞報導中明顯「醫療化」的報導,應該給予抽查與警告。
3、媒體在處理相關新聞時,不要只注意科學權威與藥廠、政府消息,也應多增加其他新聞觀點,如:婦女團體、消費者團體,提供民眾更多元角度的報導。
4、民眾也可以當一個聰明閱聽人,當對於相關醫療報導內容有疑問,各媒體皆有觀眾服務中心,可以主動電話詢問該醫學研究是哪一單位或醫師發表,也可以透過網路查詢相關訊息,而不是對所有報導內容全盤接受。
Recently the discussions on sexual ability appeared more frequently on newspaper and television. Among them, the extensive reports on Viagra that treats erectile dysfunction (ED) had remarkable influence on men’s and women’s health and their relationships. Once talked about inside family, the sexual ability now becomes a public topic because of Viagra. Therefore, there are critiques on the sale promotion by the media and Viagra abuse as a sexual stimulant. Is erectile dysfunction a disease? Do media reports facilitate the medicalization of sexual ability?

The purposes of this study are as following:
1. To analyze the impressions of Viagra reports and their relationships with the medicalization of sexual ability;
2. To investigate the history of therapies for erectile dysfunction (ED) and Viagra reports;
3. To examine the media’s strategy of reporting Viagra’s effect on treating ED

This study utilized the triangle cross examination method of the qualitative analysis that included content analysis, comment analysis, and in-depth interview. We collected the news about Viagra on the Ming Sheng News and the United Daily News from March 1st, 1998 to December 31st, 2003. The samples only included the reports written by journalists and foreign agencies. Content and comment analyses were done on the 570 samples acquired. We also collected the reports from seven press meetings by the Pfizer Pharmaceuticals, the manufacturer of Viagra. They were compared with the reports from the Chinese Daily Times, the United Daily News, and the Min Sheng News. In-depth interviews were done by two journalists, three pharmaceutical public relationship staff members, one urologist, and a government official, in order to understand the medicalization process of sexual ability.

The important findings of this study were:
Journalists’ broadcasts of doctors’ comment facilitated the medicalization of sexual ability. They provided indirect assistance to the pharmaceutical companies to promote the therapeutic drugs for sexual dysfunction. Government’s policies and attitudes led to the fact the media reports promoted the medicalization of sexual ability. Doctors, pharmaceutical companies, and journalists interacted and they assisted the medicalization of sexual ability in the medical news.


The reports showed the following:
1. Viagra reports increased considerably since May 1998. The peak of major reports was between the end of 1998 when it was approved by Department of Health and March 22nd, 1999, when it was on market.
2. Contents of Viagra reports had two categories,(1).pros and (2). cons. Pros quoted urologists or researches. Cons quoted non-urologist doctors or feminist organizations.
3. Pros had Western biomedical viewpoints that emphasized the need of treatment for sexual dysfunction that was regarded as a disease. Prescription of Viagra required the professional judgment of doctors and it helped the men with ED desiring to obtain an erection.
4. The Viagra reports had the content that transformed as following. (1). Progression of marketing Viagra; (2). Side-effects of Viagra; (3). Dramatic efficacy of Viagra; (4). Loss of attention on Viagra and the appearance of alternatives, new drugs and or other therapies to treat ED; (5). Men’s active role and ignorance of women’s sexual function.
5. Cons had two categories, psychosocial model and critiques of the medicalization. The former contributed sexual dysfunction to the psychosocial factors that included faulty marriage, extreme desire to have a son, and inappropriate environment. The latter opposed the monopoly of Western medicine that over-emphasized the importance of medical care or hospital visits and it uncovered the profits of pharmaceutical companies or the medical system and the validity of population health.
6. The construct strategies of reporting sexual dysfunction: the once confidential sexual issues were discussed in public because of Viagra that treated erectile dysfunction. In addition, it was a prescription drug. So the reports suggested the medical coverage of sexual dysfunction and emphasized the early intervention.
7. The construct strategies of Viagra’s efficacy on sexual dysfunction included: (1). Medical authorities, extensive scientific research evidence, and investigation data emphasized the importance of treatment; (2).Viagra was a prescription drug that required the doctor’s instructions; (3). Government used policy to regulate it; (4). Patients shared their experience of successful sex by taking Viagra.
8. Cons construct strategies with reporting sexual ability provided solutions other than Viagra. It was not some elixir and did not need a psychosocial adjuvant, as stated by psychiatrists. Sexual degeneration was a normal aging process of older men. Feminist groups and scholars of sociology or public health also suggested that sexual dysfunction might not need therapy.
9. Journalists’ news quoted the content of the press meeting provided by the pharmaceutical companies. Few journalists questioned the accuracy of the research. The interviewees mainly consisted of the invited urologists, cardiologists, or researchers, but not doctors of other specialties.
10. There were exaggerations in the news reports about Viagra and sexual ability. Journalists and doctors accepted the sponsorship by pharmaceutical companies to attend international conferences. Only a few of those journalists invited did not attend although they were aware that it was related to sales and promotion. They were reluctant to give up the related news clues and competitions. Doctors thought their sales and promotions of pharmaceutical companies created the mutual benefits among doctors, patients, and pharmaceutical companies. Television media had pressure from limited interview time and audience rate, so they could not examine problems in depth and were prone to be the tools of doctor’s profession. Publication journalists had more time for investigation but still had difficulty to outsmart doctors.

This study had four suggestions:
1. Journalists should be skeptical of the medical profession. Media should re-evaluate the news content about sexual ability and avoid the commercial influence on journalism profession.
2. Current laws and regulations do not allow the promotion of drugs masked as news. Government should inspect and warn news organization with obvious medicalization.
3. When handling related news, the media should not pay attention only to scientific authorities, pharmaceutical companies, or government announcements, but also include other viewpoints from the other groups such as feminists, consumers, etc, to provide more broad-spectrum information.
4. People can act as a smart agent who read and listen. Every media agency had customer’s service center. When there was doubt about any related medical report, everyone could call them and ask for the source of institution or author, or could seek information on the Internet, but rather than accept all the content blindly.
第一章 緒論 第一節 研究動機 -------------------------------------------------------------1 第二節 研究重要性------------------------------------------------------------3 第三節 研究目的---------------------------------------------------------------5 第四節 研究問題---------------------------------------------------------------6
第二章 文獻探討 第一節 醫藥新聞報導的重要性---------------------------------------------7 第二節 醫療化-----------------------------------------------------------------14
第三節 威而鋼與性功能勃起障礙-----------------------------------------21
第四節 威而鋼報導研究-----------------------------------------------------31
第三章 研究方法 第一節 研究設計--------------------------------------------------------------35
第二節 樣本材料--------------------------------------------------------------40
第三節 內容分析--------------------------------------------------------------41
第四節 論述分析--------------------------------------------------------------44
第四章 內容分析結果 第一節 樣本特質--------------------------------------------------------------45 第二節 威而鋼相關新聞報導內容-----------------------------------------45 第三節威而鋼治療性功能新聞之內容-------------------------------------46
第五章 論述分析結果------------------------------------------------------------------47 第一節 表面敘事結構分析--------------------------------------------------48 第二節 意涵結構分析--------------------------------------------------------64 第三節 藥廠新聞稿與記者文本分析比較--------------------------------76
第四節 性功能的醫療化-----------------------------------------------------79
第六章 深度訪談分析結果 第一節 醫藥記者之深度訪談分析------------------------------------------81 第二節 藥廠公關之深度訪談分析------------------------------------------86 第三節 政府官員深度訪談分析---------------------------------------------90 第四節 泌尿科醫師深度訪談分析------------------------------------------95
第五節 三角交叉檢視法分析結果------------------------------------------98
第七章 討論與建議
第一節 研究重要發現---------------------------------------------------------100
第二節 討論---------------------------------------------------------------------103
第三節 研究限制---------------------------------------------------------------108
第四節 建議---------------------------------------------------------------------109
附件一 威而鋼仿單內容-------------------------------------------------------------------110
附件二 藥廠記者會新聞稿----------------------------------------------------------------112
附件三 深度訪談問題----------------------------------------------------------------------118
參考文獻
英文文獻--------------------------------------------------------------------------------------121
中文文獻--------------------------------------------------------------------------------------123
參考文獻
英文文獻
David Gilbert. Life Style Medicines. British Medical Journal 2000; 321:1341-1344
George Dunea. Say no to Viagra.British Medical Journal 1998;316:1755
Wright RW.Mass media as of medical information.Journal of Communication 1975;25(3):171-173.
Simpkins JD,Brenner DJ.Mass Media Communication and Health.In:Dervin B,Voigt MJ eds.Progress in Communication Sciences.NJ:Ablex,1984;275-97
Krieghbaum H.Reporting science information through the mass media.J Quarterly 1963;40:291-2
Greenberg RH,Freimuth VS,Bratic E.A Content Analytic Study of Daily newspaper Coverage of Cancer.In:Communication Yearbook 3,1981;645-54
Burkett W.Medical and health science news.News Reporting:Science,Medicine and High Technology.Chapter 8 Iowa State:University Press,1986.
Shepherd RG.Selectivity of sources:Reporting the Marijuana Controversy 1981(spring):129-37
Glynn CJ,Times AR.Sensationalism in Science issues:a case study.J Quarterly1982:59(1);126-204
Friedman R.Doctors and reporters treat problems of science in news.Editor and Publisher1965:March 20;9.
Zola, IK. Medicine as an Institution of Social control.Sociological Revies 1972;20:487-504
Zola, IK.Social-medical inquires:Recollections,reflections,and reconsiderations.Philadelphia:Temple University Press.(1983)
Conrad, P. & Schneider, J.W.Looking at levels of medicalization:a comment on strong’s critique of thesis of medical imperalism, Socail Science and Medicine, 1980;14A, 75-79.
Conrad,Peter and Joseph W.Schneider.Deviance and medicalization:From Badnessto Sickness(expanded edition).Philadelphia:Temple University press(1992)
Goldstein,M.S.The Health Movement:Promoting Fitness in America.(1992)NewYork:Twayne.
Kaufer PA.Mckinlay SM.Estrogen-replacement therapy:the production of medical knowledge and the emergence of policy,In:E.Lewin&V.Blesesn(eds).Women,Health and Healing:Toward a New Perspective(pp.113-138).New York:Tavistock,1985.
Riessman,C.K.Woman and medicalization:a new perspective.Social Policy, 1983;14:3-18.
Fox,R.C.The medicalization and demedicalization of American society,In:Daedalus,Journal of the American Academy of Arts and Sciences,a Special Issue on:Doing better and Feeling Worse:Health in the United States,1977;106(1):409-413.
Illich,I.Medical Nemesis:the Expropriation of Health.New York:Pantheon Books,1976.
Tifer,Leonore.SEX Is Not A Natural Act&Other Essays,(Westview).1995.
M.Braun.MD, ‘Viagra Effect’-Influence of Mass Media on Patient Behavior,Urol Int 2001;66:145-148.
中文文獻
徐美苓、劉仲冬、孫光煥、張王黎文:「威而鋼傳播現象座談會」。新聞學研究1999;61:285-96。
張玨:女性觀點看威而鋼。台灣醫學 1999;3卷3期
成令方、傅大為:初論台灣泌尿科的男性身體觀。健與美的歷史研討會,1999。
藍素禎:台灣健康傳播之分析-以威而鋼新聞為例。陽明大學衛生福利研究所碩士論文,2001。
孫志硯:醫藥新聞中的性與身體以威而鋼與威而柔的媒體再現為例。全球化時代與新聞報導研討會,2003、11、29。
李瞻:科學、環境、醫藥新聞的報導。李瞻主編,新聞採訪學,再版。台北:三民,1985:235-60
謝瀛春:門外漢談科學傳播。科學月刊,1979:10(1);125-8
陳婷玉:民生報醫藥新聞的內容分析-一九八二至一九九一年。政治大學新聞研究所碩士論文,1992。
謝瀛春:科學與大眾媒介,初版,台北:遠流,1994。
余萬益:我國主要報紙報導醫事新聞的趨勢分析。政治作戰學校新聞研究所碩士論文,1992。
Crook M(新新聞編譯):向神話挑戰。打破曲線神話,台北:新新聞文化,1995:129-148。
翁秀琪:大眾傳播理論與實證,台北:三民,1992:117。
江才健:科學報導問題之省思。報學,1998:7(10);24-5。
徐美苓:愛滋病與媒體。台北:巨流,2001。
鄭瑞城:透視傳播媒介。台北:天下文化,1990。
楊志弘:台灣地區傳播者研究之探討。民意研究季刊,1994:189;67-97。
吳嘉苓:性別醫學與權力,(性屬關係上:性別與社會、建構)王雅各編,頁385-418,台北:心理出版社,1999。
張苙雲:醫療與社會:醫療社會學的探索。台北:巨流,1998。
張玨、張菊惠:婦女健康與醫療化:以停經期/更年期為例。婦女與兩性學刊1998;9:145-185。
胡幼慧:新醫療社會學-批判與另類的視角。台北:心理出版社,2001。
李絜:更年期報導之分析-以中國時報、聯合報為例。台大衛政所碩士論文,2001。
許碧珊:以充權觀點檢視更年期自助團體成員之經驗歷程。台大衛政所碩士論文,2001。
林文源:「醫療化」再思考。台大社會學刊;2001;29:213-250。
張玨、張菊惠:男性更年期研究的回顧。台灣衛誌;2003,22(2)。
江漢聲:百分之百威而鋼,讓你性愛不打烊。台北:宏欣文化,2003。
簡邦平:威而鋼在台三年成效,女性性功能暨威而鋼上市三週年研討會,2002。
方世榮:行銷管理學。台北:東華,2003。
黃才倍、郭育成、蔡德成等:威而鋼在醫院營運上之經濟效益與附加價值,中華民國泌尿科醫學會年會會議,2000。
林蕙瑛,從威而鋼藥效的深度訪談看女性性功能在兩性關係的角色,2002,女性性功能暨威而鋼上市三週年研討會.
張錦華,女為悅已者瘦:瘦身廣告風潮,大眾媒介效果與閱聽人詮釋,台北:女書,2001.
張錦華,傳播批判理論。台北:黎明文化。1994.
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