Oakland University William Beaumont School of Medicine, Michigan, Rochester, United States.
Royal Oak Beaumont Hospital, Michigan, Rochester, United States.
Bioethics. 2023 Jul;37(6):515-522. doi: 10.1111/bioe.13044. Epub 2022 May 16.
Since the inception of bioethics, some theorists have denied that clinical ethicists have ethics expertise, understood as the ability to give justified moral recommendations in patient cases. These denials have caused considerable alarm, leading some to argue that the entire discipline needs to be fundamentally reconsidered. Although this debate has been a source of academic attention for decades, these challenges to ethics expertise can now be either resolved by showing they are based on an untenable view of moral justification or dissolved by showing they result from a rash of equivocations on key phrases such as what it means to give a "moral recommendation," or "furnish answers" in an ethics consultation. Like the blind men and the elephant, what sounds like disagreement may only be theorists describing different aspects of the same facilitation approach to clinical ethics endorsed by the American Society for Bioethics and Humanities. While the question of whether ethicists have ethics expertise can be resolved or dissolved, theorists should refocus on how much (content-thick vs. content-thin) expertise ethicists have. Here, theorists need not commit themselves to a general view but can be content-thick on some issues and content-thin on others.
自生命伦理学创立以来，一些理论家否认临床伦理学家具有伦理学专业知识，即有能力在患者案例中给出合理的道德建议。这些否认引起了相当大的恐慌，导致一些人认为整个学科都需要从根本上重新考虑。尽管这场辩论已经成为学术界关注的焦点长达几十年，但现在可以通过表明这些否认是基于对道德论证的不可接受的观点，或者通过表明它们是由于对关键短语的轻率使用而产生的，例如在伦理咨询中给出“道德建议”或“提供答案”的含义，来解决或消解对伦理学专业知识的这些挑战。就像盲人摸象一样，表面上的分歧可能只是理论家们在描述美国生物伦理学和人文学会认可的临床伦理学的同一促进方法的不同方面。虽然伦理学家是否具有伦理学专业知识的问题可以得到解决或消解，但理论家们应该重新关注伦理学家具有多少（内容丰富与内容单薄）专业知识。在这里，理论家们不必坚持一种普遍观点，而可以在一些问题上内容丰富，在其他问题上内容单薄。
