Moreno J D
Division of Humanities in Medicine, State University of New York Health Science, Brooklyn 11203.
J Med Philos. 1988 Nov;13(4):411-32. doi: 10.1093/jmp/13.4.411.
Consensus is commonly identified as the goal of ethics committee deliberation, but it is not clear what is morally authoritative about consensus. Various problems with the concept of an ethics committee in a health care institution are identified. The problem of consensus is placed in the context of the debate about realism in moral epistemology, and this is shown to be of interest for ethics committees. But further difficulties, such as the fact that consensus at one level of discourse need not imply consensus at another, oblige us to look more closely at the deliberative process itself. That yields two complementary methods of deliberation that have proven their worth. Finally, placing ethics committees in the context of Dewey's philosophy of social intelligence suggests that consensus should be regarded primarily as a condition rather than as the goal of inquiry.
共识通常被视为伦理委员会审议的目标，但尚不清楚共识在道德层面的权威性究竟何在。文中指出了医疗机构中伦理委员会概念存在的各种问题。将共识问题置于道德认识论中关于实在论的辩论背景下，结果表明这对伦理委员会具有重要意义。但还存在其他难题，比如在一个话语层面达成的共识并不一定意味着在另一个层面也能达成共识，这就迫使我们更仔细地审视审议过程本身。由此产生了两种已证明其价值的互补性审议方法。最后，将伦理委员会置于杜威的社会智能哲学背景下表明，共识应主要被视为探究的一个条件而非目标。
