Spielthenner Georg
Department of Philosophy and Applied Ethics, The University of Zambia, P.O. Box 32379, Lusaka, Zambia.
Med Health Care Philos. 2008 Dec;11(4):465-73. doi: 10.1007/s11019-008-9128-0. Epub 2008 Mar 11.
Many medical interventions have both negative and positive effects. When health care professionals cannot achieve a particular desired good result without bringing about some bad effects also they often rely on double-effect reasoning to justify their decisions. The principle of double effect is therefore an important guide for ethical decision-making in medicine. At the same time, however, it is a very controversial tool for resolving complex ethical problems that has been criticized by many authors. For these reasons, I examine in this paper whether the principle of double effect can serve as a basis for ethical decisions in medicine. The conclusion reached in this article is that even though this principle has desirable effects on clinical conduct, it is only an unreliable guide and physicians and nurses cannot feel secure in continuing to use this principle for ethical guidance.
许多医疗干预措施都有消极和积极的影响。当医护人员在无法实现某种特定的预期良好结果而不产生一些不良影响时，他们常常依靠双重效应推理来为自己的决策辩护。因此，双重效应原则是医学伦理决策的重要指南。然而，与此同时，它也是解决复杂伦理问题的极具争议性的工具，受到了许多作者的批评。出于这些原因，我在本文中探讨双重效应原则是否可以作为医学伦理决策的基础。本文得出的结论是，尽管这一原则对临床行为有可取的影响，但它只是一个不可靠的指南，医生和护士不能放心地继续使用这一原则进行伦理指导。
