University of Pennsylvania, Philadelphia, Pennsylvania, USA.
University of Notre Dame, South Bend, Indiana, USA.
J Med Philos. 2021 Apr 2;46(2):188-218. doi: 10.1093/jmp/jhaa038.
Debates about the ethics of health care and medical research in contemporary pluralistic democracies often arise partly from competing religious and secular values. Such disagreements raise challenges of balancing claims of religious liberty with claims to equal treatment in health care. This paper proposes several mid-level principles to help in framing sound policies for resolving such disputes. We develop and illustrate these principles, exploring their application to conscientious objection by religious providers and religious institutions, accommodation of religious priorities in biomedical research, and treatment of patients' religious views in doctor-patient encounters. Given that no sound set of guiding principles yields precise solutions for every policy dispute, we explore how morally sound democracies might deliberatively resolve such policy issues, following our proposed principles. Taken together and carefully interpreted, these principles may help in guiding difficult decision making in the indefinitely large realm where government, medical providers, and patients encounter problems concerning religion and medicine.
当代多元化民主社会中有关医疗保健和医学研究的伦理问题的争论往往部分源于相互竞争的宗教和世俗价值观。这些分歧提出了在宗教自由主张和医疗保健平等待遇主张之间进行平衡的挑战。本文提出了几项中级原则,以帮助制定解决此类争议的合理政策。我们制定并说明了这些原则,探讨了它们在宗教提供者和宗教机构的基于良心的反对、在生物医学研究中对宗教优先事项的适应以及在医患接触中对待患者宗教观点方面的应用。鉴于没有一套完善的指导原则能够为每个政策争议提供精确的解决方案,我们探讨了在遵循我们提出的原则的情况下,道德健全的民主国家如何审慎地解决这些政策问题。这些原则综合起来并经过仔细解释,可以帮助指导在政府、医疗服务提供者和患者遇到涉及宗教和医学的问题的无限广泛的领域中进行艰难的决策。