Shelp E E
Soc Sci Med. 1984;18(4):351-60. doi: 10.1016/0277-9536(84)90125-4.
The contribution that the virtues can make to the moral life in general and to the moral community constituted in the patient-physician relationship more specifically is gaining increased scholarly attention. This paper explores the meaning and relevance of the virtue of courage for patients and physicians. Courage is presented as a virtue for physicians in addition to the excellences of competence and compassion and a virtue for patients in addition to the excellences of compliance and gratitude. In agreement with Alasdair MacIntyre, courage is held to be necessary, at times, to our expression of care and concern for one another. The patient-physician relationship is shown to be a context in which care and concern is expressed, a context in which courage can be a relevant virtue. Certain conditions are listed as necessary to courage: freedom, fear, risk, uncertainty, an endangered good and a morally worthy end. Equivalents to these necessary conditions are discussed and held to be potentially present in patient-physician encounters. Physicians are pictured as a 'sustaining presence' who have duties toward patients of 'encouragement' that can be fulfilled in ways relative to the requirements of each circumstance. Patients are held to have a duty to learn about the nature of human existence and to develop the character necessary to its negotiation. Patients and physicians can be agents of courage who come together in a context of care and concern where certain goods are preserved even, at times, in the midst of loss. Thus, courage is presented as a relevant and important moral virtue for the patient-physician relationship in which those qualities that define who we are as a moral community are expressed and sustained.
美德对一般道德生活，特别是对医患关系中构成的道德共同体所能做出的贡献，正越来越受到学术关注。本文探讨了勇气这一美德对患者和医生的意义及相关性。勇气被视为医生除能力卓越和富有同情心之外的一种美德，也是患者除顺从和感恩之外的一种美德。与阿拉斯代尔·麦金太尔的观点一致，勇气有时被认为是我们表达对彼此的关心和关切所必需的。医患关系被证明是一个表达关心和关切的情境，在这个情境中，勇气可以成为一种相关的美德。文中列出了勇气的某些必要条件：自由、恐惧、风险、不确定性、受到威胁的善以及道德上有价值的目的。文中讨论了这些必要条件的等效物，并认为它们可能存在于医患接触中。医生被描绘成一种“支持性的存在”，他们对患者负有“鼓励”的责任，这种责任可以根据每种情况的要求以不同方式履行。患者被认为有责任了解人类存在的本质，并培养应对其所需的品质。患者和医生可以成为勇气的践行者，他们在关心和关切的情境中走到一起，在这个情境中，即使有时在损失之中，某些善也能得以保存。因此，勇气被视为医患关系中一种相关且重要的道德美德，在这种关系中，定义我们作为道德共同体成员身份的那些品质得以表达和维系。
