Bakhurst D
Queen's University, Kingston, Ontario, Canada.
J Med Ethics. 1992 Jun;18(2):63-6. doi: 10.1136/jme.18.2.63.
This article challenges Jennifer Jackson's recent defence of doctors' rights to deceive patients. Jackson maintains there is a general moral difference between lying and intentional deception: while doctors have a prima facie duty not to lie, there is no such obligation to avoid deception. This paper argues 1) that an examination of cases shows that lying and deception are often morally equivalent, and 2) that Jackson's position is premised on a species of moral functionalism that misconstrues the nature of moral obligation. Against Jackson, it is argued that both lying and intentional deception are wrong where they infringe a patient's right to autonomy or his/her right to be treated with dignity. These rights represent 'deontological constraints' on action, defining what we must not do whatever the functional value of the consequences. Medical ethics must recognise such constraints if it is to contribute to the moral integrity of medical practice.
本文对珍妮弗·杰克逊最近为医生欺骗患者的权利所做的辩护提出了质疑。杰克逊认为，说谎和故意欺骗在一般道德层面存在差异：虽然医生初步看来有不撒谎的义务，但不存在避免欺骗的此类义务。本文论证了两点：其一，对案例的审视表明，说谎和欺骗在道德上往往是等同的；其二，杰克逊的立场基于一种道德功能主义，这种功能主义误解了道德义务的本质。与杰克逊的观点相反，本文认为，说谎和故意欺骗在侵犯患者的自主权或其受到尊严对待的权利时都是错误的。这些权利代表了对行为的“道义论约束”，规定了无论后果的功能价值如何我们都绝不能做的事情。医学伦理学若要促进医疗实践的道德完整性，就必须承认此类约束。
