Gallagher Siun, Little Miles, Hooker Claire
Sydney Health Ethics, Faculty of Medicine, The University of Sydney, Camperdown, NSW, 2006, Australia.
Medical Humanities, Sydney Health Ethics, Faculty of Medicine, The University of Sydney, Camperdown, NSW, 2006, Australia.
Health Care Anal. 2019 Jun;27(2):93-109. doi: 10.1007/s10728-018-0356-z.
In this analysis of the ethical dimensions of doctors' participation in macroallocation we set out to understand the skills they use, how they are acquired, and how they influence performance of the role. Using the principles of grounded moral analysis, we conducted a semi-structured interview study with Australian doctors engaged in macroallocation. We found that they performed expertise as argument, bringing together phronetic and rhetorical skills founded on communication, strategic thinking, finance, and health data. They had made significant, purposeful efforts to gain skills for the role. Our findings challenge common assumptions about doctors' preferences in argumentation, and reveal an unexpected commitment to practical reason. Using the ethics of Paul Ricoeur in our analysis enabled us to identify the moral meaning of doctors' skills and learning. We concluded that Ricoeur's ethics offers an empirically grounded matrix for ethical analysis of the doctor's role in macroallocation that may help to establish norms for procedure.
在本次对医生参与宏观资源分配伦理维度的分析中,我们旨在了解他们所运用的技能、这些技能是如何习得的,以及它们如何影响角色表现。运用扎根道德分析原则,我们对参与宏观资源分配的澳大利亚医生进行了一项半结构化访谈研究。我们发现,他们将基于沟通、战略思维、财务和健康数据的实践智慧和修辞技巧结合起来,以专业知识进行论证。他们为获得该角色所需技能做出了重大且有目的的努力。我们的研究结果挑战了关于医生在论证中偏好的常见假设,并揭示了对实践理性的意外承诺。在分析中运用保罗·利科的伦理学使我们能够确定医生技能和学习的道德意义。我们得出结论,利科的伦理学为医生在宏观资源分配中角色的伦理分析提供了一个基于实证的框架,这可能有助于确立程序规范。