Oakland University William Beaumont School of Medicine.
Am J Bioeth. 2021 Jun;21(6):5-16. doi: 10.1080/15265161.2020.1863512. Epub 2020 Dec 29.
Secular clinical ethics has responded to the problem of moral pluralism with a procedural approach. However, defining this term stirs debate: H. Tristram Engelhardt Jr. has championed a contentless proceduralism (P1), while others, conversely, argue for a proceduralism that permits some content in the form of moral claims (P2). This paper argues that the content P2 permits ought to be expanded to include some metaphysical commitments, in an approach referred to as P2+. The need for P2+ is demonstrated by analyzing and rejecting three standards (the best interest or harm principle, internal reasonability, and the child's right to an open future) used by P2 to justify overriding religiously motivated refusals of treatment for children. These approaches fail because each maintains a neutral stance regarding the truth of religious belief. This paper drives at the broader thesis that the proceduralism of secular clinical ethics requires some moral and metaphysical commitments.
世俗临床伦理学以程序方法回应道德多元主义问题。然而，对这一术语的定义引发了争议：H.特里斯屈拉姆·恩格尔哈特（H. Tristram Engelhardt Jr.）倡导一种无内容的程序主义（P1），而另一些人则相反，主张允许以道德主张形式存在一些内容的程序主义（P2）。本文认为，P2 所允许的内容应该扩大到包括一些形而上学的承诺，这一方法被称为 P2+。通过分析和拒绝 P2 用来证明对儿童宗教动机的治疗拒绝进行干预的三个标准（最佳利益或伤害原则、内部合理性以及儿童对开放未来的权利），可以证明 P2+的必要性。这些方法之所以失败，是因为它们在宗教信仰的真实性方面都保持中立立场。本文的主旨是，世俗临床伦理学的程序主义需要一些道德和形而上学的承诺。
