Identitetskonstruktioner af patienter

This article focuses on the discursive construction of patient identity in the Danish Health Act. Traditionally, the ideology of the welfare state has been based on equality and solidarity, and the state has so far been responsible for the provision of health care services. Recent research suggests, however, that the implementation of New Public Management influences the welfare model in a neo-liberal direction. The study focuses on how such underlying ideologies may influence the dominant discourses present in the Health Act and how these discourses may construct different subject positions and identities. The analysis points to two competing, hegemonic discourses: a welfare discourse and a New Public Management discourse. Those reveal an asymmetrical relationship between three groups: health professionals occupying dominant subject positions, patients empowered to make free choices within the limits stipulated by policy makers and patients constructed as objects in need of care.

本文聚焦于《丹麦医疗法案》（Danish Health Act）中患者身份的话语建构。传统上，福利国家的意识形态以平等与团结为基石，且迄今为止国家始终承担着医疗服务供给的主体责任。然而近期研究显示，新公共管理（New Public Management）的落地推行正使福利模式朝着新自由主义方向转型。本研究旨在探究这类深层意识形态如何影响《丹麦医疗法案》中的主流话语，以及这些话语又将如何建构出多元的主体立场与身份认同。分析结果揭示了两种相互博弈的霸权话语：福利话语与新公共管理话语。二者展现出三类群体间的非对称权力关系：占据主导主体地位的医疗专业人员、被赋予在政策制定者划定的框架内自主选择权利的患者，以及被建构为需接受照护的客体的患者。