摘要
在当代社会,完全或部分源自人体并应用于临床生物材料的“人源性医疗制品”具有重要的医疗与研究价值。随着科学技术的进步,人源性医疗制品被广泛地应用于维持和改善人类的生活质量。过去二十多年,临床医学对人体器官、细胞、眼角膜和其他人体组织的需求急剧增长,而供给的主要来源是自愿捐献,因此社会供给量并未跟上医学需求的增长速度。因而本文提出的问题是:人源性医疗制品的自愿捐献基础和数量增加如何可能。关于人源性医疗制品捐献的相关学术讨论多集中在个体意愿、道德意义等面向,对于动员捐献的体系处于存而不论的状态。体系的成功被默认为是“国家高层重视”或“财政投入增加”等因素作用下自然而成的结果。这种简单化的归因掩饰了动员捐献体系成功的关键实际上是建立在对人源性医疗制品的复杂性治理当中。对此本文以中华骨髓库的重启为例,借助拉图尔的行动者网络理论,对比该库重启前后的绩效表现与运作系统,论述在相似的政治经济和社会文化前提下,中华骨髓库重启后的绩效表现何以明显优于从前。研究发现,中华骨髓库的重启可以视为行动者网络拓展的过程,一方面在组织架构上“征召”了更多的社会同盟者,另一方面在动力机制上转译了造血干细胞捐献的意义,继而将政府部门的重视与财政投入的增加转化为绩效上的成功,完成拉图尔所说的“黑箱化”过程。本研究结果阐明了机构对人源性医疗制品的治理运作与组织绩效之间的紧密关联性,借此为我国人源性医疗制品的相关治理机构提供重要的行动参照与借鉴。
Medical Products of Human Origin(MPHO)include biomaterials that are fully or partially derived from the human body and used in clinical applications.Therefore they boast important medical and scientific value.Advances in science and technology have led to an increase in the availability of MPHO for use in maintaining and improving the quality of human life.Over the past two decades,the demand for human organs,cells,corneas and other human tissues in clinical medicine has increased dramatically,but social demand often exceeds supply,and the main source of supply is from donation.Thus the question raised in this paper is how it becomes possible for the voluntary donation of MPHO.Relevant academic discussions addressing MPHO focused on individual wishes and moral implications,but the system of mobilizing donations has not been talked about though it does exist.The success of the system is tacitly considered as the natural achievements of factors such as“high-level national attention”or“increased financial input”.This simplistic attribution obscures the complexity of the governance of MPHO behind the system’s success.Referring to Bruno Latour’s actor network theory(ANT),this paper takes the relaunch of Chinese Marrow Donor Program(CMDP)as an example,and compares the performance and operational systems of CMDP before and after its relaunch.Under the premise of similar politics,economy and social culture,the performance of the CMDP is obviously better than before.This paper discloses that the process of the relaunch of CMDP was a process of expanding of ANT,while on the one hand recruiting more allies in terms of structure,and at the same time,on the dynamic mechanism,translating the significance of hematopoietic stem cell donation.Then,the attention of the government departments and the increase of financial input are transformed into the success in performance,completing the“black box”process pointed out by Bruno Latour,while becoming a black box that only requires attention to its input,output,and smooth operations.The results of this study clarify the close correlation between the governance operation and organizational performance of MPHO,and provide an important action reference and lessons to learn for the relevant governance institutions of MPHO in China.
作者
孙璞玉
SUN Pu-yu(Faculty of Humanities and Social Sciences,Beijing University of Technology;Beijing Social Governance Research Center,Beijing 100124)
出处
《中央民族大学学报（哲学社会科学版）》
CSSCI
北大核心
2022年第3期99-108,共10页
Journal of Minzu University of China(Philosophy and Social Sciences Edition)
基金
国家社会科学基金青年项目“公民道德建设与人体医疗产品捐献体系研究”(项目编号:20CSH025)的阶段性成果
关键词
人源性医疗制品
捐献
造血干细胞
中华骨髓库
行动者网络理论
Medical Products of Human Origin(MPHO)
donation
hematopoietic stem cells
China Marrow Donor Program
Actor Network Theory(ANT)
作者简介
孙璞玉,北京工业大学文法学部社会工作系讲师、北京社会管理研究基地研究人员。
