Hoffmaster B
Westminster Institute for Ethics and Human Values, London, Ontario, Canada.
Soc Sci Med. 1992 Dec;35(12):1421-31. doi: 10.1016/0277-9536(92)90045-r.
Since its inception contemporary medical ethics has been regarded by many of its practitioners as 'applied ethics', that is, the application of philosophical theories to the moral problems that arise in health care. This 'applied ethics' model of medical ethics is, however, beset with internal and external difficulties. The internal difficulties point out that the model is intrinsically flawed. The external difficulties arise because the model does not fit work in the field. Indeed, the strengths of that work are its highly nuanced, particularized analyses of cases and issues and its appreciation of the circumstances and contexts that generate and structure these cases and issues. A shift away from a theory-driven 'applied ethics' to a more situational, contextual approach to medical ethics opens the way for ethnographic studies of moral problems in health care as well as a conception of moral theory that is more responsive to the empirical dimensions of those problems.
自当代医学伦理学诞生以来,许多从业者将其视为“应用伦理学”,即将哲学理论应用于医疗保健中出现的道德问题。然而,这种医学伦理学的“应用伦理学”模式面临着内部和外部的困难。内部困难指出该模式存在内在缺陷。外部困难的出现是因为该模式与该领域的工作不契合。事实上,该领域工作的优势在于其对案例和问题进行高度细致入微、具体的分析,以及对产生并构建这些案例和问题的环境和背景的理解。从理论驱动的“应用伦理学”转向更注重情境、背景的医学伦理学方法,为医疗保健中道德问题的人种志研究以及一种更能回应这些问题实证维度的道德理论概念开辟了道路。