van Gils-Schmidt Henk Jasper, Salloch Sabine
Department Health Sciences, Hamburg University of Applied Sciences, Hamburg, Hamburg, Germany.
Institute for Ethics, History and Philosophy of Medicine, Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
J Med Ethics. 2024 May 22;50(6):368-374. doi: 10.1136/jme-2023-109203.
The medical profession is observing a rising number of calls to action considering the threat that climate change poses to global human health. Theory-led bioethical analyses of the scope and weight of physicians' normative duty towards climate protection and its conflict with individual patient care are currently scarce. This article offers an analysis of the normative issues at stake by using Korsgaard's neo-Kantian moral account of practical identities. We begin by showing the case of physicians' duty to climate protection, before we succinctly introduce Korsgaard's account. We subsequently show how the duty to climate protection can follow from physicians' identity of being a healthcare professional. We structure conflicts between individual patient care and climate protection, and show how a transformation in physicians' professional ethos is possible and what mechanisms could be used for doing so. An important limit of our analysis is that we mainly address the level of individual physicians and their practical identities, leaving out important measures to respond to climate change at the mesolevels and macrolevels of healthcare institutions and systems, respectively.
鉴于气候变化对全球人类健康构成的威胁，医学界正在呼吁采取行动的声音越来越多。目前，基于理论的生物伦理分析，探讨医生在气候保护方面的规范性义务的范围和重要性，以及这种义务与个体患者护理之间的冲突，还比较少见。本文运用科斯嘉德关于实践身份的新康德主义道德理论，对相关规范性问题进行分析。我们先阐述医生气候保护义务的案例，再简要介绍科斯嘉德的理论。随后说明气候保护义务如何源自医生作为医疗专业人员的身份。我们梳理个体患者护理与气候保护之间的冲突，展示医生职业精神转变的可能性以及可用于实现这种转变的机制。我们分析的一个重要局限在于，我们主要关注个体医生层面及其实践身份，分别遗漏了医疗机构和医疗系统中观层面和宏观层面应对气候变化的重要措施。
