Spranzi Marta
Department of Science, University of Versailles, Saint-Quentin-en-Yvelines, Versailles, France.
Med Health Care Philos. 2013 Feb;16(1):93-103. doi: 10.1007/s11019-012-9398-4.
Bioethics laws in France have just undergone a revision process. The bioethics debate is often cast in terms of ethical principles and norms resisting emerging social and technological practices. This leads to the expression of confrontational attitudes based on widely differing interpretations of the same principles and values, and ultimately results in a deadlock. In this paper I would like to argue that focusing on values, as opposed to norms and principles, provides an interesting perspective on the evolution of norms. As Joseph Raz has convincingly argued, "life-building" values and practices are closely intertwined. Precisely because values have a more indeterminate meaning than norms, they can be cited as reasons for action by concerned stakeholders, and thus can help us understand how controversial practices, e.g. surrogate motherhood, can be justified. Finally, norms evolve when the interpretations of the relevant values shift and cause a change in the presumptions implicit in the norms. Thus, norms are not a prerequisite of the ethical solution of practical dilemmas, but rather the outcome of the decision-making process itself. Struggling to reach the right decision in controversial clinical ethics situations indirectly causes social and moral values to change and principles to be understood differently.
法国的生物伦理法刚刚经历了一次修订过程。生物伦理辩论常常围绕着抵制新兴社会和技术实践的伦理原则与规范展开。这导致基于对相同原则和价值观的截然不同的解读而产生对抗性态度的表达，最终导致僵局。在本文中，我想指出，与规范和原则相对，关注价值观能为规范的演变提供一个有趣的视角。正如约瑟夫·拉兹令人信服地论证的那样，“塑造生活”的价值观与实践紧密相连。正是因为价值观的含义比规范更具不确定性，它们才能够被相关利益攸关方作为行动理由引用，进而有助于我们理解诸如代孕等有争议的实践如何能够被正当化。最后，当对相关价值观的解读发生转变并导致规范中隐含的推定发生变化时，规范就会演变。因此，规范并非解决实际困境的伦理方案的先决条件，而是决策过程本身的结果。在有争议的临床伦理情境中努力做出正确决策会间接地导致社会和道德价值观的变化以及对原则的不同理解。
