Widdershoven Guy, Abma Tineke, Molewijk Bert
The EMGO Institute for Health and Care Research, Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands.
Bioethics. 2009 May;23(4):236-48. doi: 10.1111/j.1467-8519.2009.01712.x.
In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and perspectives need to be exchanged. Within hermeneutic ethics dialogue is seen as a vehicle for moral learning and developing normative conclusions. Dialogue stands for a specific view on moral epistemology and methodological criteria for moral inquiry. Responsive evaluation involves a structured way of setting up dialogical learning processes, by eliciting stories of participants, exchanging experiences in (homogeneous and heterogeneous) groups and drawing normative conclusions for practice. By combining these traditions we develop both a theoretical and a practical approach to empirical ethics, in which ethical issues are addressed and shaped together with stakeholders in practice. Stakeholders' experiences are not only used as a source for reflection by the ethicist; stakeholders are involved in the process of reflection and analysis, which takes place in a dialogue between participants in practice, facilitated by the ethicist. This dialogical approach to empirical ethics may give rise to questions such as: What contribution does the ethicist make? What role does ethical theory play? What is the relationship between empirical research and ethical theory in the dialogical process? In this article, these questions will be addressed by reflecting upon a project in empirical ethics that was set up in a dialogical way. The aim of this project was to develop and implement normative guidelines with and within practice, in order to improve the practice concerning coercion and compulsion in psychiatry.
在本文中，我们提出了一种基于诠释学伦理学和回应性评价的实证伦理学对话方法。诠释学伦理学将经验视为道德智慧的具体来源。为了深入理解道德问题，需要交流具体而详细的经验和观点。在诠释学伦理学中，对话被视为道德学习和得出规范性结论的一种手段。对话代表了一种关于道德认识论的特定观点以及道德探究的方法论标准。回应性评价涉及一种构建对话式学习过程的结构化方式，即引出参与者的故事、在（同质和异质）群体中交流经验并为实践得出规范性结论。通过结合这些传统，我们开发了一种实证伦理学的理论和实践方法，在这种方法中，伦理问题与实践中的利益相关者共同探讨并形成。利益相关者的经验不仅被伦理学家用作反思的来源；利益相关者还参与到反思和分析过程中，这一过程在实践参与者之间的对话中进行，由伦理学家提供便利。这种实证伦理学的对话方法可能会引发一些问题，比如：伦理学家做出了什么贡献？伦理理论扮演着什么角色？在对话过程中实证研究与伦理理论之间的关系是什么？在本文中，我们将通过反思一个以对话方式开展的实证伦理学项目来探讨这些问题。该项目的目的是在实践中并与实践共同制定和实施规范性指南，以改善精神病学中关于强制手段的实践。
