Baker R
Department of Philosophy, Union College, Schenectady, NY 12308, USA.
Mt Sinai J Med. 1999 Sep;66(4):212-22.
Recent philosophical work has disclosed a host of problems in our apparently natural ways of classifying things. The contemporary classification of certain groups as "minorities" exemplifies some of these problems. I argue that these classifications are arbitrary and misleading. Through examining several of the most significant ethical moments in the history of modern medicine, including the thought and conduct of Nazi physicians, the Tuskegee study, Beecher's questioning of post-war research practices and Percival's enunciation of a universalist ethic for physicians, I make a case against racial and ethnic classification of patients. Such classifications can play a destructive role in determining the sort of health care which minorities receive. Embracing them, even with the intent of improving the lot of those who do not fare well in the present health care environment, is subversive of the egalitarian stance which has been central to medical ethics since Hippocrates.
近期的哲学研究揭示了我们看似自然的事物分类方式中存在的诸多问题。将某些群体归类为“少数群体”的当代分类方式就例证了其中一些问题。我认为这些分类是武断且具有误导性的。通过审视现代医学史上几个最重要的伦理事件，包括纳粹医生的思想与行为、塔斯基吉梅毒研究、比彻对战后研究实践的质疑以及珀西瓦尔对医生普遍主义伦理的阐述，我提出反对对患者进行种族和族裔分类的观点。此类分类在决定少数群体所接受的医疗保健类型时可能会起到破坏性作用。即便怀着改善那些在当前医疗环境中处境不佳者境遇的意图而接纳这些分类，也是对自希波克拉底以来一直是医学伦理核心的平等主义立场的破坏。
