Greaves D A
Centre for Philosophy and Health Care, University College, Swansea.
J Med Ethics. 1991 Dec;17(4):189-94. doi: 10.1136/jme.17.4.189.
Section 47 of the National Assistance Act is controversial in that it makes provision for the compulsory removal and care of mentally competent adults in certain limited circumstances. A case is described in which it is argued that compulsory management could be justified. This is because the diversity and potentially conflicting nature of the relevant considerations involved in this and a restricted range of other cases, defies their being captured in any wholly rational moral scheme. It follows that if the law is to be both sensitive and just it cannot always provide definitive guidance as to how the community doctor, as the designated decision-maker, should act. The acceptance of his or her judgement is therefore necessary and depends for its proper working on trust, which can only be gained through compassion and respect for the patients concerned.
《国家援助法》第47条颇具争议,因为它规定在某些特定有限情况下可对精神健全的成年人进行强制迁移和照料。本文描述了一个案例,其中有人认为强制管理是合理的。这是因为在此案例以及其他有限案例范围内所涉及的相关考量因素具有多样性且可能相互冲突,无法被纳入任何完全合理的道德体系。因此,如果法律既要敏感又要公正,就不能总是为作为指定决策者的社区医生应如何行动提供明确指导。所以,接受其判断是必要的,而其正常运作依赖于信任,而信任只能通过对相关患者的同情和尊重来获得。