Pellegrino Edmund D
Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC, 20007, USA.
Theor Med Bioeth. 2005;26(6):469-86. doi: 10.1007/s11017-005-2201-2.
Moral absolutes have little or no moral standing in our morally diverse modern society. Moral relativism is far more palatable for most ethicists and to the public at large. Yet, when pressed, every moral relativist will finally admit that there are some things which ought never be done. It is the rarest of moral relativists that will take rape, murder, theft, child sacrifice as morally neutral choices. In general ethics, the list of those things that must never be done will vary from person to person. In clinical ethics, however, the nature of the physician-patient relationship is such that certain moral absolutes are essential to the attainment of the good of the patient - the end of the relationship itself. These are all derivatives of the first moral absolute of all morality: Do good and avoid evil. In the clinical encounter, this absolute entails several subsidiary absolutes - act for the good of the patient, do not kill, keep promises, protect the dignity of the patient, do not lie, avoid complicity with evil. Each absolute is intrinsic to the healing and helping ends of the clinical encounter.
在我们道德多元的现代社会中,道德绝对主义几乎没有或根本没有道德地位。对于大多数伦理学家和广大公众而言,道德相对主义更容易让人接受。然而,在受到追问时,每一位道德相对主义者最终都会承认,有些事情是绝对不应该做的。极少数道德相对主义者会认为强奸、谋杀、盗窃、献祭儿童在道德上是中立的选择。在一般伦理学中,那些绝对不能做的事情的清单因人而异。然而,在临床伦理学中,医患关系的性质决定了某些道德绝对主义对于实现患者的利益——这种关系本身的目的——至关重要。这些都是所有道德的首要道德绝对主义的衍生物:行善,避免作恶。在临床接触中,这一绝对主义包含几个附属的绝对主义——为患者的利益行事,不杀生,信守承诺,保护患者的尊严,不说谎,避免与邪恶同谋。每一个绝对主义对于临床接触中的治疗和帮助目的来说都是不可或缺的。