生物伦理学中的不可通约性与民主讨论

IF 1.1 1区 哲学 0 PHILOSOPHY
Nir Eyal
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引用次数: 0

摘要

通常情况下,一种卫生资源分配方式(或更广义地说,一种卫生政策)在某种价值上(例如,在促进人口总体健康方面)比另一种价值高,而在另一种价值上(例如,在促进最贫困人口健康方面)比另一种价值低。因此,有人认为,不需要理性地决定应该选择哪一种部分满足这两种要求的多种分配方式。有时,理性只能部分地、不妥协地或争论性地决定在这两种价值之间的众多 "折衷方案 "中,哪一种是最好或最值得选择的。诺曼-丹尼尔斯(Norman Daniels)、露丝-张(Ruth Chang)、马蒂恩-布特(Martijn Boot)和安德斯-赫利茨(Anders Herlitz)肯定了这一观点,我将其称为 "价值不可通约性"、"理性欠确定性 "或 "合理的分歧"。为了在卫生资源分配的多种合理折衷方案中做出决定,这些哲学家建议采用协商民主程序,主要理由有两个。首先,在这种情况下,商议可以产生决策所需的确定性。其次,通过尊重和公正地对待那些所选择的分配折衷方案对其不利的病人或社区,商议可以保护该政策的合法性。越来越多的以实践为导向的生命伦理学建议进行民主讨论,甚至比这些哲学家的建议更加广泛--几乎所有关于医疗资源分配的决策都要进行民主讨论,而不仅仅是在价值观不相容的情况下--基于上述两个理由和其他理由。此外,我们还可以对这种扩张性举措提出一种更为温和的变体,作为民主商议的理由。我的论点是,这些举措都不值得对卫生政策进行民主讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incommensurability and democratic deliberation in bioethics

Often, a health resource distribution (or, more generally, a health policy) ranks higher than another on one value, say, on promoting total population health; and lower on another, say, on promoting that of the worst off. Then, some opine, there need not be a rational determination as to which of the multiple distributions that partially fulfill both one ought to choose. Sometimes, reason determines only partially, intransitively, or contentiously which of the many “compromises” between these two values is best or most choiceworthy. Norman Daniels, Ruth Chang, Martijn Boot, and Anders Herlitz affirm this opinion, which I shall call “value incommensurability,” “rational underdeterminacy,” or “reasonable disagreement.” To decide between the multiple reasonable compromises on health resource distribution, these philosophers recommend a deliberative democratic process, on two main grounds. First, in such situations, deliberation can produce the determinacy needed for decisionmaking. Second, by treating respectfully and justly even those patients or communities for whom the distributive compromise selected is bad, deliberation shields the legitimacy of that policy. Increasingly, practically-oriented bioethics recommends democratic deliberation even more expansively than these philosophers do—for nearly every decision on health resource distribution and not only when values are incommensurate—on these two grounds and on others. And one could propose a more modest variant on this expansive move as the justification of democratic deliberation. I argue that none of these moves warrants democratic deliberation on health policy.

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来源期刊
PHILOSOPHICAL STUDIES
PHILOSOPHICAL STUDIES PHILOSOPHY-
CiteScore
2.60
自引率
7.70%
发文量
127
期刊介绍: Philosophical Studies was founded in 1950 by Herbert Feigl and Wilfrid Sellars to provide a periodical dedicated to work in analytic philosophy. The journal remains devoted to the publication of papers in exclusively analytic philosophy. Papers applying formal techniques to philosophical problems are welcome. The principal aim is to publish articles that are models of clarity and precision in dealing with significant philosophical issues. It is intended that readers of the journal will be kept abreast of the central issues and problems of contemporary analytic philosophy. Double-blind review procedure The journal follows a double-blind reviewing procedure. Authors are therefore requested to place their name and affiliation on a separate page. Self-identifying citations and references in the article text should either be avoided or left blank when manuscripts are first submitted. Authors are responsible for reinserting self-identifying citations and references when manuscripts are prepared for final submission.
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