Department of Medical Ethics, Humanities, and Law, Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, Michigan, USA.
College of Integrative Sciences and Arts, School of Applied Science and Arts, Arizona State University, Tempe, Arizona, USA.
Bioethics. 2024 May;38(4):316-325. doi: 10.1111/bioe.13275. Epub 2024 Feb 17.
In biomedical ethics, there is widespread acceptance of moral realism, the view that moral claims express a proposition and that at least some of these propositions are true. Biomedical ethics is also in the business of attributing moral obligations, such as "S should do X." The problem, as we argue, is that against the background of moral realism, most of these attributions are erroneous or inaccurate. The typical obligation attribution issued by a biomedical ethicist fails to truly capture the person's actual obligations. We offer a novel argument for rife error in obligation attribution. The argument starts with the idea of an epistemic burden. Epistemic burdens are all of those epistemic obstacles one must surmount in order to achieve some aim. Epistemic burdens shape decision-making such that given two otherwise equal options, a person will choose the option that has the lesser of epistemic burdens. Epistemic burdens determine one's potential obligations and, conversely, their non-obligations. The problem for biomedical ethics is that ethicists have little to no access to others' epistemic burdens. Given this lack of access and the fact that epistemic burdens determine potential obligations, biomedical ethicists often can only attribute accurate obligations out of luck. This suggests that the practice of attributing obligations in biomedical ethics is rife with error. To resolve this widespread error, we argue that this practice should be abolished from the discourse of biomedical ethics.
在生物医学伦理学中，人们普遍接受道德现实主义，即道德主张表达一个命题，而这些命题中的至少一些是真实的。生物医学伦理学也在承担道德义务的归因，例如“S 应该做 X”。正如我们所主张的，问题在于，在道德现实主义的背景下，这些归因中的大多数是错误或不准确的。生物医学伦理学家通常发布的典型义务归因未能真正捕捉到个人的实际义务。我们提供了一个关于义务归因中普遍存在错误的新论点。该论点从认识论负担的概念开始。认识论负担是指为了实现某个目标，一个人必须克服的所有认识论障碍。认识论负担影响决策，使得在两个其他方面相等的选项中，一个人将选择认识论负担较小的选项。认识论负担决定一个人的潜在义务，反之亦然，决定其非义务。对于生物医学伦理学来说，问题在于伦理学家几乎无法了解他人的认识论负担。鉴于这种缺乏了解以及认识论负担决定潜在义务的事实，生物医学伦理学家通常只能凭运气归因准确的义务。这表明，生物医学伦理学中归因义务的实践充满了错误。为了解决这种广泛的错误，我们认为，应该从生物医学伦理学的话语中废除这种做法。
