Section for Medical Ethics, Institute of Health and Society, University of Oslo, PO 1130, Blindern, NO-0318 Oslo, Norway.
Nurs Ethics. 2011 Mar;18(2):192-200. doi: 10.1177/0969733010388926.
This article contends that an ethics of care has a particular moral ontology that makes it suitable to argue for the normative significance of relational responsibilities within professional health care. This ontology is relational. It means that moral choices always have to account for the web of relationships, the relational networks and responsibilities that are an essential part of particular moral circumstances. Given this ontology, the article investigates the conditions for health care professionals to be partial and to act on the basis of particular responsibilities to their patients. We will argue that priorities could be partial in three ways: first, because there may be exceptional circumstances that allow for giving priority to one patient over another; second, because the integrity of the patient and a health care worker may be connected in special ways; and, finally, even if impartiality is essential, the institutional basis of health care must always give ample space for an ethically qualified individual and personal care for patients. Even if difficult priorities may be necessary, the conditions of institutional health care should always seek to create the prerequisites for nurses and doctors to administer proper care.
本文认为，关怀伦理有一种特殊的道德本体论，使其适合在专业医疗保健中论证关系责任的规范性意义。这种本体论是关系性的。这意味着道德选择必须考虑到关系网络，以及作为特定道德情境的重要组成部分的关系网络和责任。鉴于这种本体论，本文探讨了医疗保健专业人员偏袒和根据对患者的特殊责任采取行动的条件。我们将认为，优先次序可以从以下三个方面偏倚：第一，因为可能存在特殊情况，允许优先考虑一个病人而不是另一个病人；第二，因为病人和医疗工作者的完整性可能以特殊的方式联系在一起；最后，即使公正性是必不可少的，医疗保健机构的基础也必须始终为有道德资质的个人和对病人的个人护理提供充分的空间。即使需要做出艰难的优先选择，机构医疗保健的条件也应该始终寻求为护士和医生提供适当护理创造前提。
