Braunack-Mayer A J
Department of Public Health, University of Adelaide, Australia.
J Med Ethics. 2001 Apr;27(2):98-103. doi: 10.1136/jme.27.2.98.
Whilst there has been considerable debate about the fit between moral theory and moral reasoning in everyday life, the way in which moral problems are defined has rarely been questioned. This paper presents a qualitative analysis of interviews conducted with 15 general practitioners (GPs) in South Australia to argue that the way in which the bioethics literature defines an ethical dilemma captures only some of the range of lay views about the nature of ethical problems. The bioethics literature has defined ethical dilemmas in terms of conflict and choice between values, beliefs and options for action. While some of the views of some of the GPs in this study about the nature of their ethical dilemmas certainly accorded with this definition, other explanations of the ethical nature of their problems revolved around the publicity associated with the issues they were discussing, concern about their relationships with patients, and anxiety about threats to their integrity and reputation. The variety of views about what makes a problem a moral problem indicates that the moral domain is perhaps wider and richer than mainstream bioethics would generally allow.
尽管关于道德理论与日常生活中的道德推理之间的契合度存在大量争论，但道德问题的定义方式却很少受到质疑。本文对南澳大利亚州15名全科医生（GP）进行的访谈进行了定性分析，以论证生物伦理学文献定义伦理困境的方式仅涵盖了外行对伦理问题本质的部分观点。生物伦理学文献根据价值观、信仰和行动选择之间的冲突与抉择来定义伦理困境。虽然本研究中一些全科医生对其伦理困境本质的某些观点确实符合这一定义，但他们对问题伦理本质的其他解释则围绕着与他们所讨论问题相关的公开性、对他们与患者关系的担忧以及对其诚信和声誉受到威胁的焦虑。关于是什么使一个问题成为道德问题的各种观点表明，道德领域可能比主流生物伦理学通常所允许的更广泛、更丰富。
