Rulli Tina, Millum Joseph
Clinical Center Department of Bioethics, National Institutes of Health, Bethesda, Maryland, USA.
Clinical Center Department of Bioethics, National Institutes of Health, Bethesda, Maryland, USA Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA.
J Med Ethics. 2016 Apr;42(4):260-4. doi: 10.1136/medethics-2013-101643. Epub 2014 Apr 30.
Clinicians and health researchers frequently encounter opportunities to rescue people. Rescue cases can generate a moral duty to aid those in peril. As such, bioethicists have leveraged a duty to rescue for a variety of purposes. Yet, despite its broad application, the duty to rescue is underanalysed. In this paper, we assess the state of theorising about the duty to rescue. There are large gaps in bioethicists' understanding of the force, scope and justification of the two most cited duties to rescue--the individual duty of easy rescue and the institutional rule of rescue. We argue that the duty of easy rescue faces unresolved challenges regarding its force and scope, and the rule of rescue is indefensible. If the duty to rescue is to help solve ethical problems, these theoretical gaps must be addressed. We identify two further conceptions of the duty to rescue that have received less attention--an institutional duty of easy rescue and the professional duty to rescue. Both provide guidance in addressing force and scope concerns and, thereby, traction in answering the outstanding problems with the duty to rescue. We conclude by proposing research priorities for developing accounts of duties to rescue in bioethics.
临床医生和健康研究人员经常会遇到拯救他人的机会。救援案例可能会产生救助处于危险中的人的道德义务。因此，生物伦理学家出于各种目的利用了救援义务。然而，尽管救援义务应用广泛，但对其分析却不够深入。在本文中，我们评估了关于救援义务的理论现状。生物伦理学家对两种最常被引用的救援义务——个体的轻易救援义务和机构的救援规则——的效力、范围和正当性的理解存在很大差距。我们认为，轻易救援义务在其效力和范围方面面临尚未解决的挑战，而救援规则是站不住脚的。如果救援义务要帮助解决伦理问题，就必须解决这些理论差距。我们指出了另外两种较少受到关注的救援义务概念——机构的轻易救援义务和专业救援义务。这两种义务都为解决效力和范围问题提供了指导，从而有助于回答救援义务中悬而未决的问题。我们最后提出了生物伦理学中发展救援义务理论的研究重点。
