Rudnick Abraham
Department of Behavioral Sciences, Tel Aviv University School of Medicine, Tel Aviv 69978, Israel.
Health Care Anal. 2002;10(4):391-402. doi: 10.1023/A:1023431310918.
Dialogical ethics are a procedural alternative to substantive ethics such as consequentialism, deontology, principlism, casuistry, virtue ethics and care ethics. Dialogical ethics are procedural in that they do not establish goods in advance, unlike substantive ethics, but rather determine goods through a procedure enacted by the actual parties involved (although some substantive notion of justice may still be required); and they are dialogical in that the procedure is that of dialogue, involving both empathic critical discussion and negotiation. A fundamental tenet of dialogical ethics may be the use of appropriate rules of order regulating dialogue among the parties involved. Some of the central characteristics of such rules of order are that they are reciprocally regulated by dialogue, that they override other ethical considerations, and that they institute empathic critical discussion and negotiation within the ethical dialogue. Dialogical bioethics are the application of dialogical ethics to ethical problems in medicine. The approach of dialogical bioethics has proven fruitful for resolving bioethical problems such as that of medical futility, where approaches of substantive ethics have reached an impasse. There is room for further study of special challengeswithin dialogical bioethics, such as the incompetence of some involved parties, conflicts of interests of third parties, and the cost-effectiveness of this ethical approach.
对话伦理学是一种相对于诸如后果主义、义务论、原则主义、决疑论、美德伦理学和关怀伦理学等实质伦理学的程序性替代方案。对话伦理学具有程序性，因为与实质伦理学不同，它并不预先确立善，而是通过实际参与各方所制定的程序来确定善（尽管可能仍然需要某种实质的正义观念）；它具有对话性，因为该程序是对话程序，涉及共情批判性讨论和协商。对话伦理学的一个基本原则可能是使用适当的秩序规则来规范参与各方之间的对话。这种秩序规则的一些核心特征是，它们由对话相互调节，它们优先于其他伦理考量，并且它们在伦理对话中建立共情批判性讨论和协商。对话生物伦理学是将对话伦理学应用于医学中的伦理问题。对话生物伦理学方法已被证明在解决诸如医疗无效性等生物伦理问题方面富有成效，而实质伦理学方法在这些问题上已陷入僵局。在对话生物伦理学内部，对于一些特殊挑战，如某些参与方无行为能力、第三方利益冲突以及这种伦理方法的成本效益等，仍有进一步研究的空间。
