Liao Lester
McGill University, Montréal, Canada.
J Med Philos. 2025 Feb 4;50(1):25-35. doi: 10.1093/jmp/jhae040.
Physicians are shaped by sociological and philosophical factors that often differ from those of their patients. This is of particular concern in pluralistic societies when navigating ethical disagreements because physicians often misunderstand or even dismiss patient perspectives as being irrational. This paper examines these factors and why many physicians approach ethics as they do while elucidating various patient perspectives and demonstrating how they make sense when considered from a different cultural worldview. Many physicians are trained in contexts that are WEIRD: Western, educated, industrialized, rich, and democratic. These sociological characteristics tend to go hand in hand with the trio of individualism, secularism, and existentialism. These then shape an approach to ethics that focuses on the individual patient, makes no reference to the divine, and focuses on a patient's personal desires. This contrasts significantly with many patients who are collectivistic or religious, and then make rational decisions based on other values. The social fact of pluralism implores physicians to temper confidence in their own cultures while considering others to promote mutual understanding and improved care. This paper concludes with a discussion of how bridges can be built across cultures without sliding into relativism, beginning with recognizing and communicating our shared moral intuitions.
医生受到社会学和哲学因素的影响，这些因素往往与他们的患者不同。在多元社会中处理伦理分歧时，这一点尤其令人担忧，因为医生常常误解甚至忽视患者的观点，认为这些观点不合理。本文探讨了这些因素，以及为什么许多医生会以他们的方式处理伦理问题，同时阐明各种患者观点，并展示从不同文化世界观的角度考虑时这些观点是如何合理的。许多医生是在具有“WEIRD”特征的环境中接受培训的：西方、受过教育、工业化、富裕和民主。这些社会学特征往往与个人主义、世俗主义和存在主义这三者紧密相连。这些因素进而形成了一种伦理处理方式，这种方式关注个体患者，不提及神圣事物，并关注患者的个人愿望。这与许多具有集体主义或宗教信仰、并基于其他价值观做出理性决策的患者形成了显著对比。多元主义的社会现实要求医生在考虑他人时，要克制对自身文化的自信，以促进相互理解和改善医疗服务。本文最后讨论了如何在不陷入相对主义的情况下跨文化搭建桥梁，首先要认识并交流我们共有的道德直觉。
