한국 의료 담론에 나타난 신자유주의적 통치성과 주체화

Abstract

For the last 20 or so years, Korean society has accelerated its transition to neo-liberalism, and that transition to neo-liberalism has brought about significant change in the area of medicine, too. Neo-liberalism is creating a crucial chance to construct new subjectivation particularly for doctors, those involved in specialized jobs in the area of medicine. The purpose of this study is to examine the formation of subjects and discourse in the medical system of this era under the timely context of neo-liberalism. In detail, this author is going to investigate whom doctors are becoming through the discussion of medical privatization and medical industrialization, what discourse strategies are employed in that process, and what characteristics are shown in the practice of discourse and formation of subjects in order to see what this era we are living in is demanding from the subjects of doctors and how they are becoming those fundamentally. To attain the goal, based on the discussion of Foucault’s authority and subjects, and also on medicine, this researcher uses the concepts of governmentality and subjectivation to analyze neo-liberalistic discourse of medicine. The concept of governmentality is very effective in explaining the relationship between subjects and authority because it embraces not only the directive ruling of authority but also such matters as ruling and command, coordination, and adjustment that are taking place everyday. Especially in the sense that individuals come to make themselves a particular subject in their own autonomous way through their free will, it can be regarded as an effective frame of concept to explain today’s ruling system based on freedom. In detail, in order to understand how the discourses surrounding medical privatization try to define ‘good doctors’, this study distinguishes the areas of reality from those of medical drama and examines not only the strategies of practicing discourse in each of the areas but also technologies used to form subjects and their effects. This study particularly focuses on the roles of media producing discourses either accepting or resisting ruling technologies in this era of neo-liberalism. Also, to consider the effects of neo-liberalistic discourse of medicine including medical privatization on doctors who have been seizing dominant positions in the area of medicine so far in terms of the relations of authority, this researcher analyzes medical drama having doctors as main characters. According to the findings of this study, there exist discoursal cracks, contradictories, and competitions in medical drama which can never be defined as being identical or homogenous. This is so in the aspect that the discourse of medical drama works as productive authority to construct ‘doctors as subjects developing themselves’. Although the discourse of neo-liberalism in reality and discourse of neo-liberalism in medical drama are produced centering around interests respectively, these two areas share a single value in the aspect of forming subjects, the doctors of this neo-liberalistic era. They are ‘the subjects ruling themselves’ by motivating themselves with a sense of purpose, controlling and managing themselves, and growing themselves. This has us compulsively realize the fact that unexceptionally, the doctors involved in specialized jobs, too, are living in the era when they have to develop themselves constantly, compete with others, and accept the result. But what is noticeable is that medical drama accepts the trend of neo-liberalistic change of medicine and attempts to practice resistance to it at the same time. The doctors in the drama are depicted as subjects who are defensive and struggling to stop the penetration of new discourse such as medical privatization and hospital commercialization.