De George R T
J Med Philos. 1982 Feb;7(1):87-100. doi: 10.1093/jmp/7.1.87.
The hospital has legal liability. Does it also have moral responsibility? Is it a moral agent, and if so in what sense? There are two issues involved, one conceptual and the other normative. The conceptual issue is whether a hospital can be morally responsible. If seen not only as a physical facility but as a formal organization, it can be said to act rationally, choose between alternatives, and affect human beings. It thus satisfies the criteria for moral responsibility, even though it is not a person. Though moral responsibility can be attributed intelligibly to a hospital, such responsibility can be assumed only by those within it who act for it. Such responsibility is agent responsibility and may be shared in a number of ways. Hospital responsibilities can be separated from the professional moral responsibility and the personal moral responsibility held by doctors, nurses, and others within a hospital. Assuming these three types of responsibility makes possible conflicts of responsibility for those who hold them. Normatively, the moral responsibility of the hospital is appropriately limited by its purpose and is primarily administrative. It has designatable moral responsibilities to its patients, doctors and nurses, and the public. These can be distinguished from the responsibilities of doctors and nurses to the public. The responsibility of a doctor on the hospital staff is different from the responsibility of a doctor who simply practices in the hospital; that of a staff nurse from that of a private nurse. The difference is in large part a function of the one sharing the responsibility of the hospital and the other not. An analysis of a hospital's moral responsibilities suggests structures appropriate to a hospital that wishes to meet its moral responsibilities.
医院负有法律责任。它是否也负有道德责任呢？它是一个道德主体吗？如果是，在何种意义上是呢？这里涉及两个问题，一个是概念性的，另一个是规范性的。概念性问题是医院是否能承担道德责任。如果不仅将医院视为一个物理设施，而且视为一个正式组织，那么可以说它能理性行事，在不同选择之间做出抉择，并影响人类。因此，它满足道德责任的标准，尽管它不是一个人。虽然可以合理地将道德责任归于医院，但这种责任只能由医院内部为其行事的人来承担。这种责任是行为主体的责任，可以通过多种方式分担。医院的责任可以与医院内医生、护士及其他人员所承担的职业道德责任和个人道德责任区分开来。对于承担这些责任的人来说，承担这三种责任可能会导致责任冲突。从规范性角度看，医院的道德责任因其目的而受到适当限制，且主要是管理性的。它对患者、医生、护士和公众负有明确的道德责任。这些责任可以与医生和护士对公众的责任区分开来。医院工作人员中的医生的责任与仅在医院行医的医生的责任不同；医院护士的责任与私人护士的责任不同。这种差异在很大程度上取决于一方分担医院的责任而另一方不分担。对医院道德责任的分析表明了适合希望履行其道德责任的医院的结构。
