Wear Stephen
Center for Clinical Ethics and Humanities in Health Care, The University at Buffalo, VA Medical Center, NY 14215, USA.
J Med Philos. 2002 Aug;27(4):433-45. doi: 10.1076/jmep.27.4.433.8607.
Many teachers of bioethics often express concern, in their writings and otherwise, about the theoretical basis (or lack of it) of bioethics and the allied issue of relativism. The companion articles by Tong and Momeyer are in this vein and rightly address such issues within the context of a liberal arts education. This article addresses such issues in a different venue, i.e., bioethics teaching in the clinical sphere of health care institutions. It presumes to suggest that many of these theoretical concerns, as well as the threat of relativism, seldom arise in this sphere. Rather, a broad based, well accepted body of moral truth has been fashioned over the last quarter century and it is this that clinical bioethics regularly keys to and to which most moral dilemmas are referred for resolution. The various forms of this pedagogy, e.g., case consultations or institutional policy statements, are charted out in this regard, as well as the often tactical character of much of this teaching, i.e., not "what should we do?", but "how might we best do it?". The article then goes on to conclude with a reflection on the use and abuse of power in clinical bioethics teaching and consultation.
许多生物伦理学教师常在其著作及其他场合表达对生物伦理学理论基础(或缺乏理论基础)以及相关相对主义问题的担忧。佟和莫迈尔的相关文章即属此类,且恰当地在文科教育背景下探讨了这些问题。本文则在不同背景下探讨这些问题,即医疗机构临床领域的生物伦理学教学。本文认为,许多此类理论问题以及相对主义的威胁在该领域很少出现。相反,在过去四分之一世纪里已形成了一个基础广泛、广为接受的道德真理体系,临床生物伦理学通常以此为依据,大多数道德困境也据此得以解决。本文阐述了这种教学法的各种形式,如案例咨询或机构政策声明,以及这种教学的许多策略性特点,即不是“我们该怎么做?”,而是“我们怎样才能做得最好?”。文章最后对临床生物伦理学教学与咨询中权力的使用与滥用进行了反思。