Brodeur D
SSM Health Care System, St. Louis, USA.
Health Prog. 1995 Sep-Oct;76(7):30-5, 40.
Catholic healthcare has traditionally relied on four major ethical principles--nonmaleficence, beneficence, autonomy, and justice--to address conflicts between various goods. However, all healthcare now finds itself facing great changes. "Principleism" is too limited to guide the Church's health ministry through the current crisis. But the Church possesses a body of social justice teachings that may provide healthcare with the necessary guidance. Eight inseparable but distinct themes are found in the social teachings: human dignity, human solidarity, the option for the poor, the common good, human rights, social justice, stewardship, and liberation. The eight themes are here applied to five critical healthcare issues: the patient-physician relationship, the right to choose, healthcare as a communal good, rationing and limits, and work and its implications. The Church's social teachings may provide us with a basis for a structural reexamination of healthcare--including Catholic healthcare. In that analysis, we may find that Catholic healthcare has developed practices and standards that are at odds with its own teachings. Such an analysis will be painful, but it must be done.
传统上，天主教医疗保健依靠四项主要伦理原则——不伤害、行善、自主和公正——来解决各种利益之间的冲突。然而，如今所有医疗保健行业都面临着巨大变革。“原则主义”过于有限，无法指导教会的卫生事业度过当前危机。但教会拥有一系列社会正义教义，可能为医疗保健提供必要的指导。在社会教义中可以找到八个不可分割但又各不相同的主题：人的尊严、人类团结、优先选择穷人、共同利益、人权、社会正义、管理和解放。这八个主题在此应用于五个关键的医疗保健问题：医患关系、选择权、作为公共利益的医疗保健、配给与限制以及工作及其影响。教会的社会教义可能为我们对医疗保健——包括天主教医疗保健——进行结构性重新审视提供一个基础。在这种分析中，我们可能会发现天主教医疗保健所形成的做法和标准与其自身教义不一致。这样的分析会很痛苦，但必须进行。
