Lee W R
Br J Ind Med. 1977 Nov;34(4):274-80. doi: 10.1136/oem.34.4.274.
ABSTRACT Exposure of persons to conditions at work may involve some risk to health. It is not possible always to ensure that exposure can be kept below a level from which it may be categorically stated that there is no risk. The decision that has to be made, what to be done, poses an ethical problem. What principles are available for examining such ethical problems? Two theories from the study of ethics seem relevant. On the one hand Intuitionism asserts that we possess a moral sense which, correctly applied, enables us to determine what is a right action. The familiar use of 'conscience' and the teachings of some of the influential Western religions follow this theory. On the other hand Utilitarianism (in particular Objective Utilitarianism) asserts that we may judge the rightness of an action by looking at its consequences. This theory, translated into legislative reform, has provided a substantial basis for much of the social reforming legislation of the last century. In economic terms it appears as cost benefit analysis. Despite its attraction and almost plausible objectivity, Utilitarianism requires the quantification and even costing of consequences which cannot always be measured (for example, emotions) but which from an important part of the totality of life. Decisions about the right course of action are required politically but cannot always be made objectively. They may require an element of judgement—a correct application of the moral sense—to use the Intuitionists' phrase. Doctors, used to making ethical decisions in the clinical setting, must examine carefully their role when contributing to ethical decisions in the industrial setting.
摘要 人们在工作中接触某些环境条件可能会对健康造成一定风险。不可能总是确保接触水平能一直保持在可明确宣称无风险的程度以下。必须做出的决策，即该做什么，引发了一个伦理问题。有哪些原则可用于审视这类伦理问题呢？伦理学研究中的两种理论似乎与之相关。一方面，直觉主义断言我们拥有一种道德感，若正确运用，能使我们判定什么是正确的行为。常见的“良知”用法以及一些有影响力的西方宗教教义都遵循这一理论。另一方面，功利主义（尤其是客观功利主义）断言我们可以通过考量行为的后果来判断其正确性。这一理论转化为立法改革后，为上世纪的许多社会改革立法提供了重要基础。从经济角度看，它表现为成本效益分析。尽管功利主义具有吸引力且看似客观合理，但它要求对后果进行量化甚至估算成本，而后果往往难以衡量（例如情感），但情感却是生活总体的重要组成部分。在政治层面需要做出关于正确行动方针的决策，但这些决策并非总能客观做出。用直觉主义者的话说，它们可能需要一定的判断力——正确运用道德感。医生惯于在临床环境中做出伦理决策，在为工业环境中的伦理决策提供建议时，必须仔细审视自己的角色。
