Department of Health, Care and Nursing, University College of Gjøvik, Gjøvik, Norway.
J Med Ethics. 2009 Nov;35(11):684-7. doi: 10.1136/jme.2009.030981.
In a seminal article in the Journal of Medical Ethics, Søren Holm and Tuja Takala analysed two protechnology arguments in bioethics: the hopeful principle and the automatic escalator. They showed how these arguments relate to problematic arguments such as the precautionary principle and the empirical slippery slope argument, and argued that they should be used with great caution. The present article investigates the recent debate on proton beam therapy, where the hopeful principle and the automatic escalator are identified. However, the debate reveals a series of other arguments that deserve similar caution. An analysis of these arguments indicates that the roots of their fallacies are to be found in the ignorance of the uncertainties about risks and benefits and an overly optimistic attitude towards technology and progress. The point is not to argue against proton therapy, but rather to point out that flawed arguments for new technologies, such as proton therapy, can actually hamper their implementation instead of promoting it. Patients deserve the best technology available, not only on the basis of the best available evidence, but also on the basis of the best arguments.
在《医学伦理学杂志》上的一篇重要文章中，Søren Holm 和 Tuja Takala 分析了生物伦理学中的两个蛋白质技术论证：有希望原则和自动扶梯。他们展示了这些论证如何与预防性原则和经验性滑坡论证等有问题的论证相关联，并认为应该谨慎使用这些论证。本文探讨了质子束治疗的最新争论，其中确定了有希望原则和自动扶梯。然而，这场辩论揭示了一系列其他值得同样谨慎对待的论点。对这些论点的分析表明，它们谬论的根源在于对风险和收益的不确定性的无知，以及对技术和进步的过度乐观态度。关键不是反对质子治疗，而是要指出，对新技术（如质子治疗）的有缺陷的论证实际上可能会阻碍其实施，而不是促进其实施。患者应该得到最好的现有技术，不仅要基于最佳现有证据，还要基于最佳论证。
