Pickering Neil John
Bioethics Centre, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
J Med Ethics. 2020 Dec 17;47(12):e59. doi: 10.1136/medethics-2020-106695.
In a recent JME article, Guidry-Grimes, Dean and Victor offer some signal and challenging insights into the ethical analysis of covert medication (in general) and in particular when administered via food. They warn of impacts on identity likely to emerge from using food in this way. In particular, they caution against allowing families to be involved in covert medication, in the light of their central role in sustaining identity. Their analysis has particular purchase in resource rich contexts and those contexts where individual identity is a central concern. But it is less clear that the article's insights are relevant to other contexts. This article places the analysis of covert medication and identity in a wider context, arguing both that the focus on identity is equally significant when analysing potential alternatives to covert medication, such as coercion; and that the ethical analysis of covert medication offered by Guidry-Grimes, Dean and Victor lacks global applicability. It seems to lack application particularly in resource-poor contexts, and in cultures where identity and community are interconstituted.
在最近发表于《医学伦理学杂志》的一篇文章中，吉德瑞 - 格里姆斯、迪恩和维克多对秘密用药（总体而言），尤其是通过食物给药的情况进行了一些显著且具有挑战性的伦理分析。他们警告了以这种方式使用食物可能对身份认同产生的影响。特别是，鉴于家庭在维持身份认同方面的核心作用，他们告诫不要让家庭参与秘密用药。他们的分析在资源丰富的背景以及个人身份认同是核心关注点的背景下具有特殊意义。但该文章的观点在其他背景下是否相关则不太明确。本文将秘密用药与身份认同的分析置于更广泛的背景中，认为在分析秘密用药的潜在替代方式（如强制手段）时，对身份认同的关注同样重要；并且吉德瑞 - 格里姆斯、迪恩和维克多所提供的秘密用药伦理分析缺乏全球适用性。它似乎尤其在资源匮乏的背景下以及身份认同与社区相互构成的文化中缺乏适用性。
