Gross Michael L
Department of Political Science, The University of Haifa, Mt Carmel, 31905 Haifa, Israel.
Bioethics. 2004 Apr;18(2):181-203. doi: 10.1111/j.1467-8519.2004.00387.x.
How should physicians act when faced with corporal punishment, such as amputation, or torture? In most cases, the answer is clear: international law, UN resolutions and universal codes of medical ethics absolutely forbid physicians from countenancing torture and corporal punishment in any form. An acute problem arises, however, in decent societies, but not necessarily liberal states, that are, nonetheless, welcome in the world community. The decent society is often governed, in whole or in part, by religious laws, and while these states abridge various human rights they are peace loving, generally tolerant, and offer their citizens wide avenues for political participation. Under these circumstances the prohibition against corporal punishment and torture weakens, often compelling physicians to participate. This is true in two cases. In Rawls' hypothetical nation of Kazanistan, Islamic law is the order of the day, and amputations and corporal punishment play an integral part in the execution of traditional Islamic justice. In Israel, torture is sometimes used to elicit the information needed to thwart impending terror attacks. In each case, a physician's participation is essential. In light of the near universal condemnation that accompanies torture and corporal punishment, physicians can only appeal to norms anchored in collective well-being and concern for life that override respect for human dignity in these societies. Western societies have consistently rejected this reasoning, but it is part and parcel of life in the decent society.
当面对诸如截肢或酷刑之类的体罚时,医生应该如何行事?在大多数情况下,答案是明确的:国际法、联合国决议以及普遍的医学伦理准则绝对禁止医生容忍任何形式的酷刑和体罚。然而,在体面的社会中却出现了一个尖锐的问题,这些社会不一定是自由国家,但在国际社会中却是受到欢迎的。体面的社会往往全部或部分地由宗教法律治理,虽然这些国家侵犯了各种人权,但它们热爱和平,通常具有宽容性,并为其公民提供广泛的政治参与途径。在这种情况下,对体罚和酷刑的禁令就会削弱,常常迫使医生参与其中。有两种情况就是如此。在罗尔斯设想的卡赞斯坦国,伊斯兰法是日常的规则,截肢和体罚在执行传统伊斯兰司法中起着不可或缺的作用。在以色列,有时会使用酷刑来获取挫败即将发生的恐怖袭击所需的信息。在每种情况下,医生的参与都是必不可少的。鉴于酷刑和体罚几乎遭到普遍谴责,医生只能诉诸基于集体福祉和对生命的关切的规范,而这些规范在这些社会中优先于对人类尊严的尊重。西方社会一直拒绝这种推理,但这却是体面社会生活中不可或缺的一部分。