陌生人伦理"?论临床伦理学中的 "了解病人"。

IF 2.3 2区 哲学 Q1 ETHICS
Medicine Health Care and Philosophy Pub Date : 2024-09-01 Epub Date: 2024-06-08 DOI:10.1007/s11019-024-10213-y
Joar Björk, Anna Hirsch
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引用次数: 0

摘要

如果是陌生人之间的互动,或者是熟人之间的互动,那么伦理要求的形式和功能可能会有所不同。斯蒂芬-图尔敏(Stephen Toulmin)对 "陌生人伦理 "和 "亲密关系伦理 "进行了区分,这一观点也适用于医疗保健领域。在某些情况下,医护人员(HCP)了解他们的病人(相当于 "亲密伦理"),而在某些情况下,医护人员不了解他们的病人(相当于 "陌生人伦理")。医护人员是否认识病人,对于医学伦理的核心概念和原则所产生的规范性要求是否有区别?我们认为,这个问题尚未得到令人满意的回答。一旦我们弄清了 "了解病人 "的含义,我们就会发现,这种区别与医疗保健中一些棘手的自主权问题(例如,关于预先指示或以自主权为名的家长制)尤其相关,而与正义和恩惠原则的要求相比,区别似乎较小。我们详细论证了为什么了解病人在医疗保健过程中具有伦理价值。因此,医疗保健系统应为医护人员提供了解病人的沃土,以及促进治疗连续性的结构。要做到这一点,仍有许多问题需要澄清,这是医学伦理学的一项重要任务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An "ethics of strangers"? On knowing the patient in clinical ethics.

The shape and function of ethical imperatives may vary if the context is an interaction between strangers, or those who are well acquainted. This idea, taken up from Stephen Toulmin's distinction between an "ethics of strangers" and an "ethics of intimacy", can be applied to encounters in healthcare. There are situations where healthcare personnel (HCP) know their patients (corresponding to an "ethics of intimacy") and situations where HCP do not know their patients (corresponding to "an ethics of strangers"). Does it make a difference for normative imperatives that follow from central concepts and principles in medical ethics whether HCP know their patients or not? In our view, this question has not yet been answered satisfactorily. Once we have clarified what is meant by "knowing the patient", we will show that the distinction is particularly relevant with regard to some thorny questions of autonomy in healthcare (e.g., regarding advance directives or paternalism in the name of autonomy), whereas the differences with regard to imperatives following from the principles of justice and beneficence seem to be smaller. We provide a detailed argument for why knowing the patient is ethically valuable in encounters in healthcare. Consequently, healthcare systems should provide fertile ground for HCP to get to know their patients, and structures that foster therapeutic continuity. For this to succeed, a number of questions still need to be clarified, which is an important task for medical ethics.

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来源期刊
CiteScore
4.30
自引率
4.80%
发文量
64
期刊介绍: Medicine, Health Care and Philosophy: A European Journal is the official journal of the European Society for Philosophy of Medicine and Health Care. It provides a forum for international exchange of research data, theories, reports and opinions in bioethics and philosophy of medicine. The journal promotes interdisciplinary studies, and stimulates philosophical analysis centered on a common object of reflection: health care, the human effort to deal with disease, illness, death as well as health, well-being and life. Particular attention is paid to developing contributions from all European countries, and to making accessible scientific work and reports on the practice of health care ethics, from all nations, cultures and language areas in Europe.
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