Centre for Medical Ethics, University of Oslo Faculty of Medicine, Oslo, Norway
Institute for the Health Sciences, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Gjøvik, Norway.
J Med Ethics. 2024 Feb 20;50(3):195-200. doi: 10.1136/jme-2023-108906.
Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed consent. This article applies Paul's theory of transformative experience and its expansion by Carel and Kidd to investigate the implications for medical ethics. It leads to the very uncomfortable conclusion that disease involves transformative experiences in ways that can reduce people's rational decision-making ability and undermine the basic principle of respect for autonomy and the moral rule of informed consent. While such cases are limited, they are crucial for medical ethics and health policy and deserve more attention and further scrutiny.
疾病从根本上改变了许多人的生活，并且符合成为变革性体验的正式标准。根据保罗有影响力的哲学观点，变革性体验破坏了理性决策的传统标准。因此，疾病的变革性体验可能会挑战医学伦理中的基本原则和规则，例如患者自主权和知情同意。本文应用保罗的变革性体验理论及其由 Carel 和 Kidd 扩展的理论，探讨其对医学伦理学的影响。这导致了一个非常不舒服的结论，即疾病以削弱人们理性决策能力和破坏尊重自主权基本原则和知情同意道德规则的方式涉及变革性体验。虽然这种情况是有限的，但它们对医学伦理学和卫生政策至关重要，值得更多关注和进一步审查。
