彼彻姆和查瑞斯的原则主义进路及其改进

在全球化、多元化背景下,彼彻姆和查瑞斯通过寻找普世原则来容纳道德多元主义和避免道德相对主义,进而为医学伦理学提供一系列清晰、明确、有效的道德规范的努力无疑是可贵的,但其原则主义存在的突出问题是反思平衡方法在实践中不能有效解决根本性的道德冲突。针对这一不足,我们尝试提出解决道德冲突的更有希望的思路。     

生命伦理学中原则主义的局限、批判与反思

原则主义是生命伦理学领域最具影响力的理论,但它不是一个通用的工具,而是需要因文化而异。它的核心设计是共同道德和反思平衡,前者旨在保证原则的普遍适用性,后者则旨在保证各个原则在具体应用时不至于冲突,两个方面共同保证了原则主义作为一种中间原理的实用性特点。然而,原则主义并没有澄清共同道德在描述性和规范性方面的普遍性依据,也没有解释清楚如何在原则发生冲突时形成反思平衡。批判原则主义并不是对它的彻底否定,而是旨在通过考察其局限性与优点,在结合有益的批判观点及德性伦理学的反思基础上,发展一种特定文化版本的原则主义。

     

原则主义的理论进路、伦理争论及其启示

原则主义作为全球生命伦理学最有影响力的理论进路,是对生命伦理学作为一门学科问题的回答,也是经典哲学理论在该领域中脆弱性的必然结果。然而,自产生伊始,原则主义就深陷批评和质疑的漩涡之中,包含原则一致性、常识道德问题、道德地位和方法论等。对这些争论的回应和批评性意见的包容、选择性吸纳,使原则主义释放出强大的理论生命力。原则主义本质上是对于生命伦理学的思考,对于我们参与全球生命伦理学发展提供中国话语给予深刻启示。

     

科技伦理中的原则主义

原则主义是20世纪70年代产生于生命医学伦理学研究和实践领域的重要方法,近几年来随着人工智能的兴起,原则主义被不同行动主体在多层次、多领域广泛应用。然而,新兴技术引发道德难题的情境化、多元化、大众化等特征,使得原则主义在方法论意义上面临着诸如融贯性、伦理洗地、人类中心主义等多重困境。实际上,原则主义是当前科技伦理治理的有效工具,能够发挥构建科研文化的认知作用,在实践上也有利于科技伦理的多元主体参与、全球科技治理、伦理风险评估和敏捷治理,并能够为新兴技术的政策制定和立法提供价值基础。而当代原则主义的构建应遵循人与技术物相互融合、协同演化的基本理念,并非传统意义上的人类中心主义。     

诺斯替主义对后现代生命伦理学兴起的启示

后现代生命伦理学兴起,有着深刻的多方面的理论根源.其中,诺斯替主义对其形成与发展有着不可忽略的作用.具体体现在:探索路径的独特性;立足后现代道德多元化,反理性、挑战原则主义;承认道德异乡人,构建次级相对主义以及对人内在精神本性的诉求.     

境遇伦理学与生命伦理决策

境遇伦理学是方法而不是体系;境遇伦理学认为任何事物正当与否,均因具体境遇而定;爱是永恒的善;爱是唯一的规范;爱同公正是一回事;爱不是喜欢;爱证明手段之正当性;爱是当时当地做决定。境遇伦理学厌恶伦理学的律法主义,反对僵硬不变的伦理规范教条;境遇伦理学对于处理生命伦理学的一些两难问题,有重要的参考意义。     

人的尊严与生命伦理

“尊严”是频繁出现在生命伦理学中的一个概念,但关国学者麦克琳却在最近认为,尊严在生命伦理学中是个无用的概念,可以毫无损失地用其它概念,比如尊重人的自主性概念所代替。反驳了麦克琳的观点,定义了尊严的含义,认为生命伦理学的使命就是在当代生命科技高度发达的情况下如何尊重和保护人的尊严。     

重构主义儒家生命伦理学正当其时——评范瑞平教授新著《当代儒家生命伦理学》

得知范瑞平教授新书《当代儒家生命伦理学》由北京大学出版社出版,笔者近日拿到此书后于一个星期内夜以继日地精读完毕。掩卷沉思,感想颇多,连续多日思绪难平,亢奋激昂,不仅因为这本书是对一段时间来深深困扰我     

原则主义在医学伦理学领域的出场逻辑

原则主义在医学伦理学中出场逻辑的前提是伦理学中居于核心地位的道德原则及其作用。传统规范伦理道德原则始终是解决现实道德问题的出发点和落脚点,医学伦理学也不例外;然而医学伦理学不仅只是承认和应用道德原则,而且筛选出一些原则作为基本原则,然后将这些基本原则建构成原则主义的基本立场和观点,用来解决医疗卫生领域中出现的道德难题。原则主义在医学伦理学中的出场和应用确实解决了一些医疗卫生领域中的道德难题,推动了医学伦理学的新发展。但原则主义并没有像其提出者所设想的那样完美地解决所有道德难题,它本身也存在着理论上的缺陷,而且很多情况下,在实践上不仅不能解决道德困境,而且引起新的道德困境,因此需要得到进一步的修改和完善。

     

辞世教育与宗教

辞世教育在于提升临终者生命的意义与品质。通过辞世教育使人们坦然面对死亡这个不可避免的人生课题,而死亡又是各类宗教最关注的内容,各宗教都有对死亡奥秘的深入诠释,对死后世界的详尽描述。宗教在辞世教育方面具有其独特性,辞世教育可以借鉴宗教智慧。     

Reflexive Principlism as an Effective Approach for Developing Ethical Reasoning in Engineering

An important goal of teaching ethics to engineering students is to enhance their ability to make well-reasoned ethical decisions in their engineering practice: a goal in line with the stated ethical codes of professional engineering organizations. While engineering educators have explored a wide range of methodologies for teaching ethics, a satisfying model for developing ethical reasoning skills has not been adopted broadly. In this paper we argue that a principlist-based approach to ethical reasoning is uniquely suited to engineering ethics education. Reflexive Principlism is an approach to ethical decision-making that focuses on internalizing a reflective and iterative process of specification, balancing, and justification of four core ethical principles in the context of specific cases. In engineering, that approach provides structure to ethical reasoning while allowing the flexibility for adaptation to varying contexts through specification. Reflexive Principlism integrates well with the prevalent and familiar methodologies of reasoning within the engineering disciplines as well as with the goals of engineering ethics education.     

Bioethics with a Difference: A Comment on McElhinney and Pellegrino

Theoretical Medicine and Bioethics -     

Clinical Pragmatism in Bioethics: A Pastoral Approach

This paper addresses the integration of the philosophical school of American Pragmatism, as articulated by John Dewey and others, with the disciplines of bioethics and pastoral care. It suggests new avenues for theological reflection in the bioethical enterprise. It was first presented as the inaugural Anton. T. Boisen Lecture in Pastoral Care and Education in 2004 under the auspices of Continuum Hospice Care, New York.Curtis W. Hart, M.Div., is Director of Pastoral Care and Education, NewYork-Presbyterian Hospital, Weill Cornell Medical Center and Lecturer in Public Health, Medicine and Psychiatry, Division of Medical Ethics at Weill Medical College, Cornell University. Correspondence to Curtis W. Hart, Cuh9001@nyp.org.     

Common morality: comment on Beauchamp and Childress

The notion of common morality plays a prominent role in some of the most influential theories of biomedical ethics. Here, I focus on Beauchamp and Childress’s models in the fourth and fifth edition of Principles of Biomedical Ethics as well as on a revision that Beauchamp proposed in a recent article. Although there are significant differences in these works that require separate analysis, all include a role for common morality as starting point and normative framework for theory construction in combination with a coherence theory of moral justification. I defend to some extent the existence and empirical significance of common morality, as delineated by Beauchamp and Childress in different versions, but criticize its normative role. It is neither convincing as a moral foundation nor well compatible with a standard coherentist justification. I suggest that the authors should give up the foundational account for a more modest account of common morality as resource of well-established moral insights and experiences, which have proved generally valid but neither sufficient nor infallible. Beauchamp’s latest proposal appears as a step in this direction; indeed, it may be the beginning of the end of his common-morality theory.