Samuel Gabrielle, Cribb Alan, Owens John, Williams Clare
Brighton and Sussex Medical School, Falmer, East Sussex, UK.
Department of Educational Research, Lancaster University, Lancaster, UK.
J Bioeth Inq. 2016 Sep;13(3):407-18. doi: 10.1007/s11673-016-9725-1. Epub 2016 Jun 22.
In this paper we contribute to "sociology in bioethics" and help clarify the range of ways sociological work can contribute to ethics scholarship. We do this using a case study of an innovative neurotechnology, functional magnetic resonance imaging, and its use to attempt to diagnose and communicate with severely brain-injured patients. We compare empirical data from interviews with relatives of patients who have a severe brain injury with perspectives from mainstream bioethics scholars. We use the notion of an "ethical landscape" as an analogy for the different ethical positions subjects can take-whereby a person's position relative to the landscape makes a difference to the way they experience and interact with it. We show that, in comparison to studying abstract ethics "from above" the ethical landscape, which involves universal generalizations and global judgements, studying ethics empirically "from the ground," within the ethical landscape foregrounds a more plural and differentiated picture. We argue it is important not to treat empirical ethics as secondary to abstract ethics, to treat on-the-ground perspectives as useful only insofar as they can inform ethics from above. Rather, empirical perspectives can illuminate the plural vantage points in ethical judgments, highlight the "lived" nature of ethical reasoning, and point to all ethical vantage points as being significant. This is of epistemic importance to normative ethics, since researchers who pay attention to the various positions in and trajectories through the ethical landscape are unlikely to think about ethics in terms of abstract agency-as can happen with top-down ethics-or to elide agency with the agency of policymakers. Moreover, empirical perspectives may have transformative implications for people on the ground, especially where focus on the potential harms and benefits they face brings their experiences and interests to the forefront of ethical and policy discussion.
在本文中，我们为“生物伦理学中的社会学”做出贡献，并有助于阐明社会学研究能够为伦理学学术研究做出贡献的多种方式。我们通过对一种创新神经技术——功能磁共振成像及其用于试图诊断重度脑损伤患者并与之交流的案例研究来做到这一点。我们将对重度脑损伤患者亲属访谈得到的实证数据与主流生物伦理学家的观点进行比较。我们使用“伦理景观”这一概念来类比主体可以采取的不同伦理立场——据此，一个人相对于该景观的位置会影响他们体验景观以及与之互动的方式。我们表明，与从“上方”研究抽象伦理（这涉及普遍概括和全局判断）的伦理景观相比，在伦理景观内部从“实地”进行实证研究呈现出一幅更加多元和差异化的图景。我们认为，重要的是不要将实证伦理学视为抽象伦理学的次要部分，不要认为只有当实地观点能够为上方的伦理学提供信息时才有用。相反，实证观点能够阐明伦理判断中的多元有利视角，凸显伦理推理的“现实生活”本质，并指出所有伦理有利视角都很重要。这对规范伦理学具有认识论上的重要性，因为关注伦理景观中各种立场及其轨迹的研究人员不太可能像自上而下的伦理学那样从抽象主体的角度思考伦理学，也不太可能将主体与政策制定者的主体混为一谈。此外，实证观点可能对实际中的人们产生变革性影响，特别是当关注他们所面临的潜在危害和益处将他们的经历和利益置于伦理和政策讨论的前沿时。
