Williamson Laura
a Glasgow Caledonian University.
Am J Bioeth. 2014;14(6):4-16. doi: 10.1080/15265161.2014.900139.
Patient and citizen participation is now regarded as central to the promotion of sustainable health and health care. Involvement efforts create and encounter many diverse ethical challenges that have the potential to enhance or undermine their success. This article examines different expressions of patient and citizen participation and the support health ethics offers. It is contended that despite its prominence and the link between patient empowerment and autonomy, traditional bioethics is insufficient to guide participation efforts. In addition, the turn to a "social paradigm" of ethics in examinations of biotechnologies and public health does not provide an account of values that is commensurable with the pervasive autonomy paradigm. This exacerbates rather than eases tensions for patients and citizens endeavoring to engage with health. Citizen and patient participation must have a significant influence on the way we do health ethics if its potential is to be fulfilled.
患者和公民参与如今被视为促进可持续健康与医疗保健的核心要素。参与活动会产生并遭遇诸多不同的伦理挑战，这些挑战有可能增强或破坏其成效。本文探讨了患者和公民参与的不同表现形式以及健康伦理学所提供的支持。有人认为，尽管患者赋权与自主性之间的联系备受瞩目，但传统生物伦理学不足以指导参与活动。此外，在生物技术和公共卫生研究中转向伦理学的“社会范式”，并未提供一种与普遍存在的自主性范式相称的价值观描述。这加剧而非缓解了患者和公民在努力参与健康事务时的紧张关系。如果要实现其潜力，公民和患者参与必须对我们开展健康伦理学的方式产生重大影响。
