Hastings Cent Rep. 2016 May;46(3):22-30. doi: 10.1002/hast.585. Epub 2016 Mar 21.
The deeply entrenched, sometimes heated conflict between the disability movement and the profession of bioethics is well known and well documented. Critiques of prenatal diagnosis and selective abortion are probably the most salient and most sophisticated of disability studies scholars' engagements with bioethics, but there are many other topics over which disability activists and scholars have encountered the field of bioethics in an adversarial way, including health care rationing, growth-attenuation interventions, assisted reproduction technology, and physician-assisted suicide. The tension between the analyses of the disabilities studies scholars and mainstream bioethics is not merely a conflict between two insular political groups, however; it is, rather, also an encounter between those who have experienced disability and those who have not. This paper explores that idea. I maintain that it is a mistake to think of this conflict as arising just from a difference in ideology or political commitments because it represents a much deeper difference-one rooted in variations in how human beings perceive and reason about moral problems. These are what I will refer to as variations of moral psychology. The lived experiences of disability produce variations in moral psychology that are at the heart of the moral conflict between the disability movement and mainstream bioethics. I will illustrate this point by exploring how the disability movement and mainstream bioethics come into conflict when perceiving and analyzing the moral problem of physician-assisted suicide via the lens of the principle of respect for autonomy. To reconcile its contemporary and historical conflict with the disability movement, the field of bioethics must engage with and fully consider the two groups' differences in moral perception and reasoning, not just the explicit moral and political arguments of the disability movement.
残疾运动与生物伦理学专业之间根深蒂固、有时甚至激烈的冲突众所周知,并已有充分的文献记载。对产前诊断和选择性流产的批判,可能是残疾研究学者与生物伦理学交锋中最显著、最复杂的问题,但残疾活动家和学者还有许多其他议题与生物伦理学发生对抗,包括医疗保健资源分配、生长抑制干预、辅助生殖技术和医师协助自杀。残疾研究学者与主流生物伦理学之间的紧张关系不仅是两个孤立政治团体之间的冲突;相反,这也是那些经历过残疾的人与那些没有经历过残疾的人之间的交锋。本文探讨了这一观点。我认为,将这种冲突仅仅归因于意识形态或政治承诺的差异是错误的,因为它代表了更深层次的差异——一种源于人类感知和推理道德问题方式的差异。我将其称为道德心理学的差异。残疾的生活经历产生了道德心理学的差异,这是残疾运动与主流生物伦理学之间道德冲突的核心。我将通过探讨残疾运动和主流生物伦理学如何通过尊重自主权原则的视角来感知和分析医师协助自杀的道德问题,来说明这一点。为了调和与残疾运动的当代和历史冲突,生物伦理学领域必须与两个群体的道德感知和推理差异进行接触并充分考虑,而不仅仅是残疾运动的明确道德和政治论点。