Tavaglione Nicolas, Martin Angela K, Mezger Nathalie, Durieux-Paillard Sophie, François Anne, Jackson Yves, Hurst Samia A
Bioethics. 2015 Feb;29(2):98-107. doi: 10.1111/bioe.12065. Epub 2013 Nov 8.
In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged - that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care - thus fleshing out a claim-based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self-respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice.
在医学伦理学文献中，人们普遍承认，弱势群体理应得到特别关注、照料或保护。弱势群体可定义为那些更有可能受到不公正对待的人，即某些合法诉求无法得到充分满足的人。这两点结合起来便产生了我们所说的“特别保护论点”。该论点称，那些合法诉求更有可能得不到充分满足的人理应得到特别关注、照料或保护。然而，只要我们不清楚什么是合法诉求，这一论点就依然模糊不清。本文旨在通过探究我们在医疗保健方面的诉求来消除这种模糊性，从而充实基于诉求的脆弱性概念。我们认为，“特别保护论点”必须充实如下内容：如果个人或群体X的某些合法诉求（即对（一）身体完整性、（二）自主性、（三）自由、（四）社会供给、（五）政府公正品质、（六）自尊的社会基础或（七）群体归属感）更有可能得不到充分满足，那么X就理应得到特别关注、照料或保护。有了对脆弱性的这种更深入理解，医疗保健伦理学中的脆弱性讨论就能摆脱模糊性，成为实践的充分依据。
