Department of Philosophy at the University of Basel, Switzerland.
Bioethics. 2011 Sep;25(7):361-9. doi: 10.1111/j.1467-8519.2011.01912.x.
In this article, we argue that a critical examination of epistemological and anthropological presuppositions might lead to a more fruitful use of theory in clinical-ethical practice. We differentiate between two views of conceptualizing ethics, referring to Charles Taylors' two epistemological models: 'monological' versus 'dialogical consciousness'. We show that the conception of ethics in the model of 'dialogical consciousness' is radically different from the classical understanding of ethics in the model of 'monological consciousness'. To reach accountable moral judgments, ethics cannot be conceptualized as an individual enterprise, but has to be seen as a practical endeavor embedded in social interactions within which moral understandings are being negotiated. This view has specific implications for the nature and the role of ethical theory. Theory is not created in the individual mind of the ethicist; the use of theory is part of a joint learning process and embedded in a cultural context and social history. Theory is based upon practice, and serves practical purposes. Thus, clinical ethics support is both practical and theoretical.
在本文中，我们认为，对认识论和人类学前提的批判性考察可能会导致在临床伦理实践中更有效地使用理论。我们区分了两种概念化伦理学的观点，这涉及到查尔斯·泰勒的两种认识论模型：“独白”与“对话意识”。我们表明，在“对话意识”模型中，伦理学的概念与“独白意识”模型中经典的伦理学理解有根本的不同。为了做出负责任的道德判断，伦理学不能被概念化为个人的事业，而必须被视为一种实践努力，嵌入在社会互动中，在这种互动中，道德理解正在被协商。这种观点对伦理理论的性质和作用具有特定的影响。理论不是由伦理学家的个人头脑创造的；理论的使用是共同学习过程的一部分，并嵌入在文化背景和社会历史中。理论基于实践，为实践目的服务。因此，临床伦理支持既是实践性的，也是理论性的。
