Department of Philosophy, Michigan State University, East Lansing, Michigan 48824-1316, USA.
J Eval Clin Pract. 2011 Oct;17(5):888-93. doi: 10.1111/j.1365-2753.2011.01721.x. Epub 2011 Aug 11.
As bioethicists increasingly turn their attention to the profession of public health, many candidate frameworks have been proposed, often with an eye toward articulating the values and foundational concepts that distinguish this practice from curative clinical medicine. First, I will argue that while these suggestions for a distinct ethics of public health are promising, they arise from problems within contemporary bioethics that must be taken into account. Without such cognizance of the impetus for public health ethics, we risk developing a set of ethical resources meant exclusively for public health professionals, thereby neglecting implications for curative medical ethics and the practice of bioethics more broadly. Second, I will present reasons for thinking some of the critiques of dominant contemporary bioethics can be met by a virtue ethics approach. I present a virtue ethics response to criticisms that concern (1) increased rigor in bioethics discourse; (2) the ability of normative theory to accommodate context; and (3) explicit attention to the nature of ethical conflict. I conclude that a virtue ethics approach is a viable avenue for further inquiry, one that leads us away from developing ethics of public health in a vacuum and has the potential for overcoming certain pitfalls of contemporary bioethics discourse.
随着生物伦理学家越来越关注公共卫生行业,许多候选框架已经被提出,通常着眼于阐明将这种实践与治疗性临床医学区分开来的价值观和基本概念。首先,我将认为,虽然这些公共卫生伦理学的独特建议很有前途,但它们源于当代生物伦理学中的问题,必须加以考虑。如果不了解公共卫生伦理学的推动力,我们就有可能开发出一套专门针对公共卫生专业人员的伦理资源,从而忽视了对治疗性医学伦理学和更广泛的生物伦理学实践的影响。其次,我将提出一些理由,说明为什么可以通过美德伦理学的方法来解决对当代主流生物伦理学的一些批评。我提出了一种美德伦理学的回应,回应了那些关注(1)生物伦理学话语中严谨性的提高;(2)规范理论适应情境的能力;以及(3)对伦理冲突本质的明确关注。我得出结论,美德伦理学的方法是进一步探究的可行途径,它使我们摆脱了在真空中发展公共卫生伦理学的局面,并有可能克服当代生物伦理学话语的某些陷阱。