Trinity College Dublin, Ireland.
Sheffield Hallam University, UK.
Nurs Ethics. 2019 Nov-Dec;26(7-8):2147-2157. doi: 10.1177/0969733018819119. Epub 2019 Jan 13.
The bioethical principle of respect for a person's bodily autonomy is central to biomedical and healthcare ethics. In this article, we argue that this concept of autonomy is often annulled in the maternity field, due to the maternal two-in-one body (and the obstetric focus on the foetus over the woman) and the history of medical paternalism in Western medicine and obstetrics. The principle of respect for autonomy has therefore become largely rhetorical, yet can hide all manner of unethical practice. We propose that large institutions that prioritize a midwife-institution relationship over a midwife-woman relationship are in themselves unethical and inimical to the midwifery philosophy of care. We suggest that a focus on care ethics has the potential to remedy these problems, by making power relationships visible and by prioritizing the relationship above abstract ethical principles.
尊重个人身体自主权是生物医学和医疗保健伦理学的核心原则。本文认为，由于母体的双重身体（以及产科关注胎儿而不是女性）以及西方医学和产科的医学家长主义历史，这种自主权概念在产科领域经常被否定。因此，尊重自主权原则在很大程度上已经成为一种空洞的言辞，而这可能掩盖了各种不道德的行为。我们认为，优先考虑助产士-机构关系而不是助产士-妇女关系的大型机构本身就是不道德的，并且不利于助产护理伦理哲学。我们建议，关注关怀伦理有潜力通过使权力关系可见并优先考虑关系而不是抽象的伦理原则来解决这些问题。
