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映射道德创伤:比较道德伤害的话语

Mapping Moral Injury: Comparing Discourses of Moral Harm.

作者信息

Wiinikka-Lydon Joseph

机构信息

University of Pardubice, Parducbice, Czech Republic.

出版信息

J Med Philos. 2019 Mar 16;44(2):175-191. doi: 10.1093/jmp/jhy042.

Abstract

Moral injury is a term whose popularity has grown in psychology and psychiatry, as well as philosophy, over the last several years. This presents challenges, because these fields use the term in different ways and draw their understanding from different sources, creating the potential for contradiction. This, however, is also an opportunity. Comparison between behavioral sciences and philosophy can help enrich understandings of harms considered not just psychological but moral. To this end, I provide an overview of the more influential writing of moral injury, mapping them into three broad discourses: clinical, juridical-critical, and structural. This overview then leads to a discussion of how comparative engagement among these discourses promises to expand on current theories of moral harm. I argue that such a comparison will demonstrate that more emphasis on structural violence will strengthen current understandings of moral injury, often understood in a more narrow sense to be a result of more direct, physical violence, allowing us to view moral injury as a result of institutional and social violence and injustices.

摘要

道德伤害是一个在过去几年里在心理学、精神病学以及哲学领域中越来越流行的术语。这带来了挑战,因为这些领域对该术语的使用方式不同,且其理解源自不同的来源,从而产生了矛盾的可能性。然而,这也是一个机遇。行为科学与哲学之间的比较有助于丰富对不仅被视为心理伤害而且被视为道德伤害的理解。为此,我概述了关于道德伤害的更具影响力的著作,并将它们归纳为三大类论述:临床的、司法批判的和结构性的。这一概述进而引发了关于这些论述之间的比较性探讨如何有望拓展当前道德伤害理论的讨论。我认为,这样的比较将表明,更多地强调结构性暴力将加强当前对道德伤害的理解,道德伤害通常在更狭义上被理解为更直接的身体暴力的结果,而这种比较能让我们将道德伤害视为制度性和社会暴力及不公正的结果。

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