Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
John Radcliffe Hospital, Oxford, UK.
J Med Ethics. 2019 Oct;45(10):631-635. doi: 10.1136/medethics-2019-105622. Epub 2019 Aug 8.
Controversial cases in medical ethics are, by their very nature, divisive. There are disagreements that revolve around questions of fact or of value. Ethical debate may help in resolving those disagreements. However, sometimes in such cases, there are opposing reasonable views arising from deep-seated differences in ethical values. It is unclear that agreement and consensus will ever be possible. In this paper, we discuss the recent controversial case of Vincent Lambert, a French man, diagnosed with a vegetative state, for whom there were multiple court hearings over a number of years. Both family and health professionals were divided about whether artificial nutrition and hydration should be withdrawn and Lambert allowed to die. We apply a 'dissensus' approach to his case and argue that the ethical issue most in need of scrutiny (resource allocation) is different from the one that was the focus of attention.
医学伦理中的争议案例本质上具有分歧性。这些分歧围绕着事实问题或价值问题展开。伦理辩论可能有助于解决这些分歧。然而，在某些情况下，由于伦理价值观的深刻差异，可能会出现相互对立的合理观点。对于能否达成一致和共识，情况并不明朗。在本文中，我们讨论了最近备受争议的法国患者文森特·兰伯特（Vincent Lambert）的案例，他被诊断为植物人，多年来经历了多次法庭听证。他的家人和医疗保健专业人员在是否应停止提供人工营养和水合作用并允许兰伯特死亡的问题上存在分歧。我们对他的案例采用了“分歧”方法，并认为最需要审查的伦理问题（资源分配）与关注的焦点不同。
