Shea Matthew
Philosophy Department, Franciscan University of Steubenville, Steubenville, OH, USA.
HEC Forum. 2025 Sep;37(3):389-410. doi: 10.1007/s10730-024-09544-3. Epub 2024 Nov 29.
The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional norms grounded in bioethical consensus. Drawing on the bioethics literature and features of professional practice, it shows that Conventional Ethics is the dominant paradigm. Then it presents a critique of Conventional Ethics, arguing that it cannot avoid the challenge of moral pluralism, it fails to address vitally important moral questions, and it is incapable of providing an essential service to the people ethicists aim to help. It ends with suggestions about how the practice of clinical ethics might overcome these problems.
“伦理”这一概念将医疗保健伦理界定为一种专业实践。然而，在临床伦理的理论与实践中，“伦理”的含义常常并不明晰。在这一问题上达成清晰的认识，对于理解临床伦理的本质以及围绕伦理学家的职业身份、恰当角色、他们应具备的培训和技能类型，以及他们是否拥有伦理专业知识的诸多争论而言至关重要。本文探讨了理解临床伦理之伦理的两种不同方式：实在伦理，它由基于道德真理的客观道德规范构成；以及传统伦理，它由基于生物伦理共识的传统规范构成。借助生物伦理文献以及专业实践的特征，本文表明传统伦理是主导范式。接着本文对传统伦理提出了批判，认为它无法回避道德多元主义的挑战，未能解决至关重要的道德问题，并且无法为伦理学家旨在帮助的人群提供一项基本服务。文章最后就临床伦理实践如何克服这些问题给出了建议。
