Spicker S F, Ratzan R M
Department of Community Medicine and Health Care, School of Medicine, University of Connecticut Health Center, Farmington 06032.
J Med Philos. 1990 Jun;15(3):327-41. doi: 10.1093/jmp/15.3.327.
In his writings, Edmund Pellegrino analyzes four deficiencies in the humanity of those who fall ill: the loss of (1) freedom of action, (2) freedom to make rational choices, (3) freedom from the power of others, and (4) a sense of the integrity of the self. Since Pellegrino's analysis and commitment to virtue-based ethics preceded much of the attention later given by philosophers to the importance of the moral principle of autonomy (in contrast to beneficence) in patient care, it is helpful to trace the source of his commitment to virtue-based ethics and his account of freedom to Aristotle's analysis of the human soul, as an entelechy of an intact and healthy living organism that, unimpeded by illness, moves itself to act, to actualize its intellectual potential in the form of making rational choices, and to free itself from the power of others by remaining independent and without need of continuous assistance, while at the same time retaining the integrity of a unified self that can act, think, and choose for itself autonomously.
埃德蒙·佩莱格里诺在其著作中分析了患病者人性中的四种缺陷:(1)行动自由的丧失;(2)做出理性选择的自由的丧失;(3)摆脱他人控制的自由的丧失;(4)自我完整性意识的丧失。由于佩莱格里诺对基于美德的伦理学的分析和坚持早于后来哲学家们对自主道德原则(与行善相对)在患者护理中的重要性的诸多关注,追溯他对基于美德的伦理学的坚持之源以及他对自由的阐述,可追溯到亚里士多德对人类灵魂的分析,即一个完整健康的生物体的隐德来希,它不受疾病阻碍,自行行动,以做出理性选择的形式实现其智力潜能,并通过保持独立且无需持续援助摆脱他人控制,同时保持一个能够自主行动、思考和选择的统一自我的完整性,这是很有帮助的。