Harvard Medical School.
Am J Bioeth. 2023 Dec;23(12):8-22. doi: 10.1080/15265161.2022.2160514. Epub 2023 Jan 6.
The medical profession contains five "spheres of morality": clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients' well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts.
医学领域包含五个“道德领域”：临床护理、临床研究、科学知识、人群健康和市场。这些不同的规范承诺要求医生根据活动的目的以不同的方式行事。例如，医师科学家在诊所中强调患者的福祉，在实验室中优先考虑科学方法，并作为制药公司的董事会成员寻求最大化股东回报。医生在医疗保健中越来越多地扮演多种角色，并经常在这些角色之间转换，从而在他们的各种角色的道德义务之间产生冲突的可能性。本文通过角色道德的视角审视整个医学道德领域。它开发了一个新颖的框架，帮助医生认识到他们的道德承诺取决于情况的性质和背景，澄清了医生面临的道德冲突，并以解决这些冲突的想法作为结论。
