Bloch Sidney, Green Stephen A
Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Melbourne, Australia 3065.
Br J Psychiatry. 2006 Jan;188:7-12. doi: 10.1192/bjp.188.1.7.
Psychiatry has not reached a consensus hitherto concerning an optimal theoretical framework for ethical decision-making and corresponding action. Various theories have been considered, but found wanting. Moreover, classic theories may contradict one another, contribute to confusion and immobilise the clinician. We have examined major theories commonly applied in bioethics, conferred with moral philosophers and psychiatrists and striven to apply more recent insights drawn from moral philosophy. We report that instead of pursuing a single theoretical framework, we should garner the strengths of compatible approaches in a synergistic way. We propose a particular complementarity of principlism--with its pragmatic focus on respect for autonomy, beneficence, non-maleficence and justice--and care ethics, a variant of virtue theory, which highlights character traits pertinent to caring for vulnerable psychiatric patients.
迄今为止，精神病学尚未就伦理决策及相应行动的最佳理论框架达成共识。人们已经考虑了各种理论，但发现它们都存在缺陷。此外，经典理论可能相互矛盾，导致混乱并使临床医生陷入困境。我们研究了生物伦理学中常用的主要理论，与道德哲学家和精神科医生进行了商讨，并努力应用从道德哲学中获得的最新见解。我们报告称，不应追求单一的理论框架，而应以协同的方式汲取兼容方法的优势。我们提出原则主义（其务实重点在于尊重自主性、行善、不伤害和公正）与关怀伦理学（一种美德理论变体，强调与照顾弱势精神病患者相关的性格特质）之间存在特别的互补性。
