Foster Charles
J Med Ethics. 2014 Jan;40(1):44-7. doi: 10.1136/medethics-2012-100763. Epub 2012 Aug 14.
This paper contends that the conventional ethical and legal ways of analysing the wrong involved in the misuse of human body parts are inadequate, and should be replaced with an analysis based on human dignity. It examines the various ways in which dignity has been understood, outlines many of the criticisms made of those ways (agreeing with many of the criticisms), and proposes a new way of seeing dignity which is exegetically consonant with the way in which dignity has been historically understood, and yet avoids the pitfalls which have led to dignity being dismissed by many as hopelessly amorphous or incurably theological. The account of dignity proposed is broadly Aristotelian. It defines dignity in terms of human thriving, and presupposes that it is possible, at least in principle, to determine empirically what makes humans thrive. It contends that humans are quintessentially relational animals, and that it is not possible (and certainly not ethically desirable) to define humans as atomistic entities. One important corollary of this is that when using dignity/thriving as a criterion for determining the ethical acceptability of a proposed action or inaction, one should ask not merely how the dignity interests of the patient (for instance) would be affected, but how the dignity interests of all stakeholders would be affected. The business of ethics is then the business of auditing all those interests, and determining the course of action which would maximise the amount of thriving in the world.
本文认为,传统上用于分析人体器官不当使用所涉及错误的伦理和法律方式并不充分,应以基于人类尊严的分析取而代之。它审视了对尊严的各种理解方式,概述了对这些方式提出的诸多批评(认同其中许多批评),并提出了一种看待尊严的新方式,这种方式在训诂学上与尊严在历史上被理解的方式相一致,同时又避免了那些导致尊严被许多人视为 hopelessly amorphous(无可救药地模糊不清)或 incurably theological(不可救药地带有神学色彩)而遭摒弃的陷阱。所提出的尊严解释大致是亚里士多德式的。它依据人类的蓬勃发展来界定尊严,并预先假定至少在原则上有可能通过实证来确定促使人类蓬勃发展的因素。它主张人类本质上是具有关联性的动物,将人类定义为原子式的实体是不可能的(而且从伦理角度肯定也不可取)。由此得出的一个重要推论是,当以尊严/蓬勃发展作为确定一项提议的行为或不作为的伦理可接受性的标准时,人们不仅应问(例如)患者的尊严利益会受到怎样的影响,还应问所有利益相关者的尊严利益会受到怎样的影响。那么伦理学的任务就是审视所有这些利益,并确定能使世界上蓬勃发展的总量最大化的行动方针。