Tsai D F
University of Manchester.
J Med Ethics. 1999 Aug;25(4):315-21. doi: 10.1136/jme.25.4.315.
The four principles approach to biomedical ethics (4PBE) has, since the 1970s, been increasingly developed as a universal bioethics method. Despite its wide acceptance and popularity, the 4PBE has received many challenges to its cross-cultural plausibility. This paper first specifies the principles and characteristics of ancient Chinese medical ethics (ACME), then makes a comparison between ACME and the 4PBE with a view to testing out the 4PBE's cross-cultural plausibility when applied to one particular but very extensive and prominent cultural context. The result shows that the concepts of respect for autonomy, non-maleficence, beneficence and justice are clearly identifiable in ACME. Yet, being influenced by certain socio-cultural factors, those applying the 4PBE in Chinese society may tend to adopt a "beneficence-oriented", rather than an "autonomy-oriented" approach, which, in general, is dissimilar to the practice of contemporary Western bioethics, where "autonomy often triumphs".
自20世纪70年代以来,生物医学伦理的四原则方法(4PBE)日益发展成为一种通用的生物伦理方法。尽管4PBE被广泛接受且广受欢迎,但它在跨文化合理性方面面临诸多挑战。本文首先明确了中国古代医学伦理(ACME)的原则和特点,然后将ACME与4PBE进行比较,以检验4PBE应用于一个特定但非常广泛且突出的文化背景时的跨文化合理性。结果表明,在ACME中可以清晰地识别出尊重自主性、不伤害、行善和公正的概念。然而,受某些社会文化因素的影响,在中国社会应用4PBE的人可能倾向于采取“以行善为导向”而非“以自主性为导向”的方法,这总体上与当代西方生物伦理的实践不同,在西方“自主性往往占上风”。