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道德认知与医学哲学的追求。

Moral perception and the pursuit of medical philosophy.

作者信息

Casarett D J

机构信息

University of Pennsylvania, Philadelphia 19104-3308, USA.

出版信息

Theor Med Bioeth. 1999 Apr;20(2):125-39. doi: 10.1023/a:1009929632148.

Abstract

This paper begins by examining the claim that the practice of medicine is essentially a moral endeavor. According to this view, all clinical practice has moral content, and each clinical situation has a moral dimension. I suggest that in order to recognize this moral dimension, clinicians must engage in an interpretive process, and that they must be able to interpret clinical data in ethical terms. However, clinicians often lack the 'moral perception' required to appreciate this moral dimension. I will argue that physicians lack moral perception when the clinical data they are given do not offer sufficient opportunity for interpretation. This paper draws on the work of Merleau-Ponty to suggest that this loss of interpretation is, paradoxically, the result of the way that patients experience illness. This thesis may be productive, first, because it suggests opportunities to explore the process of moral perception. This thesis also suggests ways for ethicists and educators to enhance clinicians' perception of the ethical dimensions of clinical practice. Finally, the concept of moral perception, when grounded in the patient's experience of illness, creates a fruitful area of inquiry that warrants inclusion in what may someday be the philosophy of medicine's canon.

摘要

本文开篇探讨医学实践本质上是一种道德行为这一观点。按照这种观点,所有临床实践都有道德内涵,且每个临床情境都有道德维度。我认为,为了认识到这一道德维度,临床医生必须参与一个解释过程,并且必须能够从伦理角度解释临床数据。然而,临床医生常常缺乏领会这一道德维度所需的“道德洞察力”。我将论证,当临床医生所获得的临床数据没有提供足够的解释机会时,他们就缺乏道德洞察力。本文借鉴梅洛 - 庞蒂的著作,指出这种解释的缺失,矛盾的是,是患者体验疾病的方式所导致的。这一论点可能富有成效,首先,因为它提出了探索道德洞察力过程的机会。该论点还为伦理学家和教育工作者提供了增强临床医生对临床实践伦理维度认知的方法。最后,基于患者疾病体验的道德洞察力概念,创造了一个富有成果的研究领域,值得纳入未来可能成为医学哲学经典的内容之中。

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