Monash University, Melbourne, VIC, Australia.
J Bioeth Inq. 2022 Mar;19(1):97-100. doi: 10.1007/s11673-021-10143-x. Epub 2022 Apr 1.
This article reflects on the assumption underlying the argument of Little et al. that "contested understandings" in the clinic are susceptible to reconciliation within a liberal framework described as "pragmatic pluralism". It is argued that no such reconciliation is possible or desirable because it is of the nature of the clinic that it provides a forum for multiple voices, ethical and cultural perspectives, and conceptual frameworks, and this is the source of its fecundity and creativity. Medicine itself cannot be represented by a single discourse, precisely because it is itself an unruly collection of practices that, despite their heterogeneity, are able to engage in productive dialogues with each other. The heteroglossia of the clinic, therefore, is not a problem to be overcome. Rather, it is a rich resource to be mobilized in accordance with its multiple inherent purposes.
这篇文章反思了 Little 等人论点中隐含的假设，即“有争议的理解”在诊所中容易在被描述为“实用多元主义”的自由框架内得到调和。本文认为，这种调和是不可能的，也是不可取的，因为诊所提供了一个论坛，让多种声音、伦理和文化观点以及概念框架得以表达，这是它富有成效和创造力的源泉。医学本身不能由单一的话语来代表，正是因为它本身就是一个杂乱无章的实践集合，尽管它们存在异质性，但能够相互进行富有成效的对话。因此，诊所的杂语现象不是一个需要克服的问题。相反，它是一种丰富的资源，可以根据其多种内在目的来调动。
