Nortvedt P, Nordhaug M
Section for Medical Ethics, Institute of General Practice and Community Medicine, University of Oslo, PO 1130, Blindern, N-0318 Oslo, Norway.
J Med Ethics. 2008 Mar;34(3):156-61. doi: 10.1136/jme.2006.020230.
The normative significance of proximity in ethics is considered, giving an overview of the contemporary debates about proximity in ethics and focusing on three main perspectives that take proximity to have normative significance. The first perspective is represented by meta-ethical positions, where a basic moral claim is said to originate from an irreducible, particular and unique otherness that shows up in human vulnerability. The second perspective presents a psychologically and philosophically based analysis of human emotions, which is taken to form a basis for rudimentary moral sensitivity and care. The third version of an ethics of proximity claims that personal relationships and partiality override impartialist and universalist ethical considerations. On the basis of this analysis, the sources of normativity and the essence of proximity as a normative consideration are elaborated. Finally, the relevance of an ethics of proximity to professional ethics in healthcare is discussed. From an ethics of proximity, it might be argued that institutions must attempt to organise medical care and nursing care so that a certain partiality and patient-centred care might be favoured and trump distributivist considerations of justice in healthcare.
本文探讨了伦理学中亲近性的规范意义，概述了当代关于伦理学中亲近性的争论，并聚焦于三种认为亲近性具有规范意义的主要观点。第一种观点以元伦理学立场为代表，认为基本的道德主张源于人类脆弱性中不可还原、特殊且独特的他异性。第二种观点呈现了一种基于心理学和哲学的人类情感分析，这种分析被视为基本道德敏感性和关怀的基础。第三种亲近性伦理学观点认为，个人关系和偏袒优先于公正主义和普遍主义的伦理考量。在此分析基础上，阐述了规范性的来源以及作为规范性考量的亲近性的本质。最后，讨论了亲近性伦理学与医疗保健职业道德的相关性。从亲近性伦理学的角度来看，或许可以认为机构必须尝试组织医疗护理，以便能够支持某种偏袒性和以患者为中心的护理，从而超越医疗保健中关于正义的分配主义考量。
