本文以透析病患團體介入醫療場域的行動，分析近三十年來台灣透析醫療社會力的轉變。本文借助Michel Foucault與行動者網絡理論，發展「意向性佈署」概念，指出在不同歷史時空的政策、與腎臟醫療專業關係、社會處境等條件下，病患團體的佈署介入使透析醫療場域呈現「集體性浮現：整體動員與社會賦體」、「場域雙元化：去正當性的權利與矛盾的集體性」、「垂直整合：新／去集體性與例行化」等三種透析醫療體制，構成透析病患團體的集體意向性。在這些模式下，不但浮現不同面貌的醫療品質議題，病患族群的集體性與社會、自我認同樣貌也不斷變形。其中各階段的透析醫療社會力也有不同可能性與限制。最後，除了在理論上試圖發展「實作體制」、「意向性佈署」分析社會力構成與轉變的概念工具外，這個個案分析也顯示，儘管當前透析病患團體數量增多，透析醫療社會力並未累積，反而以依附垂直整合體制為主，這是當前透析醫療社會力發展的隱憂與限制。

This study explores the transformation of societal agency in the field of dialysis medicine by examining the case of patients’ organizations actions in Taiwan in the last three decades. A new concept of ‘deployment of intentionality’ is devised from Michel Foucault and Actor-Network theory’s insights to portray the changing regimen of dialysis practice and social intentionality toward patients.The analysis examines the changing dialysis regimen and patients’ agency deployed by patients’ organizations and other policy, professional, and social actors in different eras: ‘emergence of collectivity: mobilization of the collective identity, and societal embodiment,’ ‘dualization of the field: de-legitimatization of rights and the contradictive collectivity,’ and ‘vertical integration: emergence and erosion of collective identity and routinitization.’Theoretically, this study elaborates the conceptual frameworks of regime of practice and deployment of intentionality to trace the transformation of societal agency. Empirically, the analysis shows a worrying future. The increasing amount of patients’ organizations does not increase the possibility of changing the regime of vertical integration and the dialysis patients’ agency is diminished.