Department of Philosophy, University at Buffalo, The State University of New York, Buffalo, New York, USA.
J Med Ethics. 2019 Mar;45(3):198-203. doi: 10.1136/medethics-2018-105069. Epub 2019 Jan 21.
Robert Veatch and others have questioned whether there are internal moral rules of medicine. This paper examines the legal regulatory model for governing professions as the autonomous exercise of professional skills and asks whether there is a theoretical basis for this model. Taking John Rawls's distinction between the justification of a practice and justification of the rules internal to the practice, this paper argues that the autonomous exercise of professional skills is justified so long as it benefits society. In opposition to Christopher Boorse, it is argued that medicine is pathocentric and that physicians exercise skills in treating pathologies. The autonomous treatment of pathologies is justified because non-interference with physicians will lead to greater treatment of pathologies and so benefit society. Finally, the analysis of medicine as the autonomous exercise of skills in treating pathologies yields the rule that physicians not be forced to cause pathologies.
罗伯特·维特和其他人曾质疑医学领域是否存在内在的道德准则。本文考察了法律监管模式在管理职业中的应用，即自主行使专业技能，并探讨了这种模式是否具有理论基础。本文借鉴了约翰·罗尔斯（John Rawls）关于实践辩护和实践内部规则辩护之间的区分，主张只要自主行使专业技能有益于社会，就具有正当性。与克里斯托弗·博尔斯（Christopher Boorse）的观点相反，本文认为医学是疾病中心论的，医生运用技能来治疗病理病症。自主治疗病理病症具有正当性，因为不干涉医生的治疗会导致更多的病理病症得到治疗，从而使社会受益。最后，将医学分析为自主治疗病理病症的技能运用，得出了医生不应被迫造成病理病症的规则。
