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脆弱性、道德责任和道德义务:医疗及相关专业人员采取工业行动的案例。

Vulnerability, Moral responsibility, and Moral Obligations: the case of Industrial Action in the Medical and Allied Professions.

机构信息

Department of Strategy, Entrepreneurship & International Business, School of Business, Quinnipiac University, 275 Mount Carmel Avenue, 06518, Hamden, CT, USA.

出版信息

Med Health Care Philos. 2022 Sep;25(3):333-349. doi: 10.1007/s11019-022-10078-z. Epub 2022 Aug 1.

Abstract

The article addresses issues at the nexus of physician industrial action, moral agency, and responsibility. There are situations in which we find ourselves best placed to offer aid to those who may be in vulnerable positions, a behavior that is consistent with our everyday moral intuitions. In both our interpersonal relationships and social life, we make frequent judgments about whether to praise or blame someone for their actions when we determine that they should have acted to help a vulnerable person. While the average person is unlikely to confront these kinds of situations often, those in the medical professions, physicians especially, may confront these and similar situations regularly. Therefore, when physicians withhold their services for whatever reason in support of industrial action, it raises issues of moral responsibility to patients who may be in a vulnerable position. Using theories of moral responsibility, vulnerability, and ethics, this paper explores the moral implications of physician industrial action. We explore issues of vulnerability of patients, as well as the moral responsibility and moral agency of doctors to patients. Determining when a person is vulnerable, and when an individual becomes a moral agent, worthy of praise or blame for an act or non-action, is at the core of the framework. Notwithstanding the right of physicians to act in their self-interest, we argue that vulnerability leads to moral obligations, that physicians are moral agents, and the imperatives of their obligations to patients clear, even if limited by certain conditions. We suggest that both doctors and governments have a collective responsibility to prevent harm to patients and present the theoretical and practical implications of the paper.

摘要

本文探讨了医生罢工行为、道德代理和责任之间的问题。在某些情况下,我们发现自己最适合为那些可能处于弱势地位的人提供帮助,这种行为符合我们日常的道德直觉。在我们的人际关系和社会生活中,当我们判断某人应该采取行动帮助弱势群体时,我们经常会对他们的行为进行赞扬或责备。虽然普通人不太可能经常遇到这些情况,但从事医疗行业的人,尤其是医生,可能会经常遇到这些或类似的情况。因此,当医生出于某种原因(例如支持罢工)拒绝提供服务时,这就涉及到了对处于弱势地位的患者的道德责任问题。本文运用道德责任、脆弱性和伦理理论,探讨了医生罢工行为的道德含义。我们探讨了患者的脆弱性问题,以及医生对患者的道德责任和道德代理问题。确定一个人是否脆弱,以及一个人何时成为道德代理人,是否应该因为某种行为或不作为而受到赞扬或责备,这是框架的核心。尽管医生有权为自身利益行事,但我们认为,脆弱性导致了道德义务,医生是道德代理人,他们对患者的义务是明确的,即使受到某些条件的限制。我们认为,医生和政府都有责任防止患者受到伤害,并提出了本文的理论和实践意义。

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