Wildes K W
Center for Ethics, Medicine and Public Issues, Baylor College of Medicine, Houston, TX 77030.
J Med Philos. 1993 Feb;18(1):33-49. doi: 10.1093/jmp/18.1.33.
Several recent attempts to develop models of moral reasoning have attempted to use some form of casuistry as a way to resolve the moral controversies of clinical ethics. One of the best known models of casuistry is that of Jonsen and Toulmin who attempt to transpose a particular model of casuistry, that of Roman Catholic confessional practice, to contemporary moral disputes. This attempt is flawed in that it fails to understand both the history of the model it seeks to transpose and the morally pluralistic context of secular, postmodern society. The practice of casuistry which Jonsen and Toulmin wish to revive is a practice set in the context of a community with a shared set of moral values and structures of moral authority. Without a set of common moral values and rankings, and a moral authority to interpret cases the casuistry of the postmodern age will be pluralistic, that is, there will be many casuistries not just one.
最近有几项构建道德推理模型的尝试，试图采用某种形式的决疑法来解决临床伦理中的道德争议。最著名的决疑法模型之一是琼森和图尔敏的模型，他们试图将一种特定的决疑法模型，即罗马天主教忏悔实践的模型，应用于当代道德争端。这种尝试存在缺陷，因为它既没有理解它试图应用的模型的历史，也没有理解世俗后现代社会的道德多元背景。琼森和图尔敏希望复兴的决疑法实践，是在一个具有共同道德价值观和道德权威结构的社群背景下进行的实践。没有一套共同的道德价值观和等级制度，以及一个解释案例的道德权威，后现代时代的决疑法将是多元的，也就是说，将会有许多种决疑法，而不仅仅是一种。
