Churchill Larry R
J Clin Ethics. 1991 Summer;2(2):95-7.
In the first section of his article, "The Role of Suffering and Community in Clinical Ethics," Erich Loewy sketches a theory of suffering. His conviction is that clinical medical ethics is not clearly rooted in theory and is inadequately grounded because of this. While acknowledging the merits of virtue ethics and casuistry, Loewy quickly dispenses with them, as contenders for this theoretical basis. Kantianism and utilitarianism are likewise rejected as "a universally acceptable grounding for ethics." In their place, Loewy proposes that "a deeper and more universal grounding can be found in the capacity of sentient beings to suffer." It is on this capacity to suffer that he builds his hierarchies of moral value, including primary, secondary, and symbolic worth. This theory of suffering should be welcomed. It promises to expand our awareness of clinical experience, and moral life generally, away from autonomy, utility, or virtue orientations toward attention to suffering and our response to it. Such a theory can give us a revitalized language to probe the issues of medical ethics. This should lead us to a careful reading of Loewy's larger work on which this article is based. Yet my enthusiasm is tempered by Loewy's noncritical acceptance of a peculiar, yet pervasive, understanding of the role and use of theory in ethics....
在其文章《痛苦与社群在临床伦理学中的作用》的第一部分,埃里希·洛伊勾勒了一种痛苦理论。他坚信临床医疗伦理学并未明确扎根于理论,正因如此,其根基并不稳固。在承认美德伦理学和决疑法的优点的同时,洛伊很快摒弃了它们,认为它们无法成为这一理论基础的有力竞争者。康德主义和功利主义同样被拒斥,因为它们“并非伦理学普遍可接受的根基”。取而代之的是,洛伊提出“在有感知能力的生物承受痛苦的能力中,可以找到更深层次、更具普遍性的根基”。他正是基于这种承受痛苦的能力构建了他的道德价值等级体系,包括首要价值、次要价值和象征价值。这种痛苦理论理应受到欢迎。它有望拓宽我们对临床经验以及一般道德生活的认识,使我们从自主性、功利性或美德导向转向关注痛苦以及我们对痛苦的回应。这样一种理论能够为我们提供一种焕发生机的语言,用以探究医学伦理学问题。这应该促使我们仔细研读洛伊以此文章为基础的篇幅更长的著作。然而,洛伊对伦理学中理论的作用与运用的一种独特却又普遍存在的理解不加批判地接受,这让我的热情有所降温……