Sider R C, Clements C D
J Med Ethics. 1984 Sep;10(3):138-42. doi: 10.1136/jme.10.3.138.
In contemporary medical ethics health is rarely acknowledged to be an ethical obligation. This oversight is due to the preoccupation of most bioethicists with a rationalist, contract model for ethics in which moral obligation is limited to truth-telling and promise-keeping. Such an ethics is poorly suited to medicine because it fails to appreciate that medicine's basis as a moral enterprise is oriented towards health values. A naturalistic model for medical ethics is proposed which builds upon biological and medical values. This perspective clarifies ethical obligations to ourselves and to others for life and health. It provides a normative framework for the doctor-patient relationship within which to formulate medical advice and by which to evaluate patient choice.
在当代医学伦理学中，健康很少被视为一种道德义务。这种疏忽是由于大多数生物伦理学家专注于一种理性主义的、契约式的伦理模式，在这种模式中，道德义务仅限于讲真话和信守承诺。这样一种伦理不太适合医学，因为它没有认识到医学作为一项道德事业的基础是围绕着健康价值观的。本文提出了一种基于生物学和医学价值观的医学伦理学自然主义模式。这种观点阐明了我们对自己和他人在生命与健康方面的道德义务。它为医患关系提供了一个规范框架，在此框架内制定医疗建议，并据此评估患者的选择。
