Roest Bernadette
Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
J Med Ethics. 2020 May 6. doi: 10.1136/medethics-2019-106016.
The current empirical research and normative arguments on physician-assisted dying (PAD) in the Netherlands seem insufficient to provide ethical guidance to general practitioners in the practice of PAD, due to a gap between the evidence and arguments on the one hand and the uncertainties and complexities as found in everyday practice on the other. This paper addresses the problems of current ethical arguments and empirical research and how both seem to be profoundly influenced by the Dutch legislative framework on PAD and a certain view on ethics. Furthermore, the paper elaborates on how other approaches to empirical research in bioethics, such as found in the broad field of narrative research, could supplement the empirical and ethical evaluation of PAD in the Netherlands. This paper also addresses the challenging question of how empirical data-in this case narratives-relate to normativity. The paper is written in the form of a personal narrative of the author, a young Dutch general practitioner and researcher in bioethics. This style is intentionally chosen, to illustrate how work context and professional background influence the observations one makes and the questions one may ask about the topic of PAD. In addition, by using this style, this paper not only gives a different perspective on a much-contested bioethical issue, but also on the challenges faced when a physician-bioethicist has to navigate different disciplinary fields and (moral) epistemological paradigms, especially since the 'empirical turn' in bioethics.
目前,荷兰关于医生协助死亡(PAD)的实证研究和规范性论证似乎不足以在PAD实践中为全科医生提供伦理指导,原因一方面是证据和论证之间存在差距,另一方面是日常实践中存在不确定性和复杂性。本文探讨了当前伦理论证和实证研究的问题,以及两者似乎如何受到荷兰PAD立法框架和某种伦理观点的深刻影响。此外,本文阐述了生物伦理学实证研究的其他方法,如在广泛的叙事研究领域中发现的方法,如何补充荷兰对PAD的实证和伦理评估。本文还探讨了一个具有挑战性的问题,即实证数据(在本文中为叙事)如何与规范性相关。本文以作者的个人叙事形式撰写,作者是一位年轻的荷兰全科医生兼生物伦理学研究员。选择这种风格是有意为之,以说明工作背景和专业背景如何影响一个人的观察以及对PAD主题可能提出的问题。此外,通过使用这种风格,本文不仅对一个备受争议的生物伦理问题提供了不同的视角,而且对医生 - 生物伦理学家在必须跨越不同学科领域和(道德)认识论范式时所面临的挑战提供了不同视角,特别是自生物伦理学的“实证转向”以来。