병원의 의료화와 의료의 병원화

Medicalization of Hospital and Hospitalization of Medicine: Conceptual Turn of Hospital and Modern Medicine

근대의 병원은 중세의 병원과 개념적 차원에서 단절됨으로써 등장할 수 있었다. 이 글에서는 근대병원과 중세병원의 단절을 병원의 의료화(Medicalization of Hospital)와 의료의 병원화(Hospitalization of Medicine)란 개념을 통해 설명한다. 여기서 병원의 의료화란 원래 구빈이 주요 목적이었던 병원이 의료 시술이 주가 되는 기관으로 변모하는 과정을 말하고, 의료의 병원화란 의료화된 병원이 이번에는 의료 자체를 병원화하는 과정을 말한다. 시간적으로는 병원의 의료화가 먼저 일어나고, 이어서 의료의 병원화가 일어난 것으로 볼 수 있다. 의료화를 통해 사회 구성원들이 모두 이용하는 보편적 시설이 된 병원은 이제 의료의 전 영역을 점차 병원 안으로 끌어들이는 의료의 병원화를 진행시키고 있다. 이는 생로병사의 전 과정이 이제 병원에서, 혹은 병원을 중심으로 이루어지고 있는 현실에서 분명하게 드러난다.

Hospital is a social institution which was designed for treating patients. Social institutions for caring the sick could be found almost every part of the world throughout the ages. However, ‘the hospital in the modern sense’ is an unique invention. The emergence of hospital became possible through the conceptual turn of the traditional institutions for caring the sick. Its process can be summarized as ‘Medicalization of Hospital.’ Initially, medical care was not an essential part of hospitals. Hospitals were the institutions for general help for the poor including the sick. The main focus of the service was to provide them with the basic necessaries such as food and bedding. The conceptual turn of hospital could take place when medical service became the essential part of the hospitals around the end of the 18th century. The medicalization of hospitals could be carried out by the following changes in three aspects. Firstly, the change of function: from caring for poor to caring for the sick. Secondly, the change of the running subject: from the churches to the laic government. Lastly, the change of the users: from the poor to the civilians. After the medicalization of the hospitals, the new conceptual turn is taking place: hospitalization of the medicine. All the medical activities are centralized around the hospitals and every important moment of human life cycle is captured in the hospitals. These conceptual change of hospitals makes hospitals a unique invention in history.