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描绘临床欺骗的道德领域

Mapping the Moral Terrain of Clinical Deception.

出版信息

Hastings Cent Rep. 2023 Jan;53(1):17-25. doi: 10.1002/hast.1454.

Abstract

Legal precedent, professional-society statements, and even many medical ethicists agree that some situations may call for a clinician to engage in an act of lying or nonlying deception of a patient or patient's family member. Still, the moral terrain of clinical deception is largely uncharted, and when it comes to practical guidance for clinicians, many might think that ethicists offer nothing more than the rule never to deceive. This guidance is insufficient to meet the real-world demands of clinical practice, and this article endeavors to articulate a framework to help clinicians better navigate the ethics of clinical deceit. The framework articulates four morally relevant dimensions of a potential deceptive act that should be examined to better determine the moral justification that might be required: the target of the act, the nature of the information, the nature of the act, and the context of the act.

摘要

法律判例、专业学会声明,甚至许多医学伦理学家都认为,在某些情况下,临床医生可能需要对患者或患者家属进行某种形式的撒谎或非撒谎欺骗。尽管如此,临床欺骗的道德领域在很大程度上仍未被探索,当涉及到为临床医生提供实际指导时,许多人可能认为伦理学家除了绝不欺骗的规则之外,别无他法。这一指导原则不足以满足临床实践的实际需求,本文试图构建一个框架,帮助临床医生更好地理解临床欺骗的伦理问题。该框架阐明了潜在欺骗行为的四个在道德上相关的维度,这些维度需要进行审查,以更好地确定可能需要的道德理由:行为的目标、信息的性质、行为的性质和行为的背景。

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