医学伦理学与生命伦理学的联系与区别

医学伦理学和生命伦理学有共同的哲学伦理学和医学的学科基因。二者都遵守共同的伦理原理和原则,但是它们实施原理原则的方法和路径却有区别。医学伦理学构建了常态下的医德原则和规范体系。在经常的医疗卫生活动中医务人员会"以义导利"。当医务人员的选择面临价值冲突时,会按照伦理学原则提出的价值顺位安排医疗卫生行为的优先顺位。生命伦理学面对的常常是高科技带来的道德冲突,没有现成的价值顺位可以套用。在生命伦理学的许多具体案例中,人们只能通过协商讨论来寻求方案,达成共识。二者都是哲学伦理学和医学的子集,两者之间有交集,但是侧重不同。     

规范与美德的并存与互补：历史视角

美德伦理与规范伦理是生成道德整体系的两个源头,也是伦理学的两大传统和两个必要的组成部分,并有其各自的特殊功能,在其长期演进的历史过程中,展示了各自的长处与短处。历史和现实表明,美德伦理的长处正是规范伦理的短处,美德伦理的短处正是规范伦理的长处。美德伦理犹如伦理大厦的地基,地基不牢,大厦就会倒塌;规范伦理犹如这座伦理大厦的四梁八柱,是支撑伦理大厦的骨架,骨架缺失,大厦焉存？美德伦理与规范伦理的关系是并存与互补的关系。认清美德伦理与规范伦理的并存与互补的关系,是建设包括医学伦理在内的社会伦理完整体系的最佳选择。

     

美德伦理与规则伦理：由对立互竞到协同互补

当代西方规范伦理学在理论形态上表现为美德伦理学与规则伦理学的对立互竞。这种对立局面导源于对立双方理论动机上的共同错误:单极化企图以及对伦理学限度的认知不足。现实道德生活是多样化的,这就决定了伦理学必须采取多元化的基本概念。因此,美德伦理与规则伦理的协同互补将是规范伦理学的未来发展趋势。     

就美德伦理的现代意义与万俊人教授商榷——以麦金太尔美德伦理思想为中心

在《美德伦理的现代意义》一文中,万俊人教授认为麦金太尔的美德伦理是在现代性道德文化语境内部对现代性进行反思。这不仅在根本上误读了麦金太尔的思想,而且基于此种误读寻求的美德伦理的现代意义掩盖了美德伦理原本应该具有的重大现实意义。本文试图通过对万俊人教授文中的核心观点进行辨析,阐明麦金太尔的美德伦理是跳出现代性道德概念框架,站在整个西方道德文化传统的立场上对现代性进行反思,并以此为基础揭示美德伦理的现代意义:对现代性道德概念框架本身进行批判反思,并指出一种符合人类道德生活客观实际的道德探究方法,即美德伦理探究方法。     

当代美国公共行政美德伦理的复兴与实践

20世纪80年代美德伦理在美国公共行政领域的复兴,使得美德与公共行政实践的内在利益紧密相关.实现公共行政的内在利益需要有德性的公共行政人员,而公共行政人员的美德决定了公共行政实践内在利益的实现.     

“医学伦理学再启程”亟待破解的医学伦理课题

面临新境遇的医学伦理学,亟待破解的医学伦理课题有：医疗资本和医疗利益集团追求利润最大化的行为对公立医疗机构公益性造成持续性损害;医学高新技术僭越伦理底线,无限制地对身体进行技术干预;医学技术权力与医学高新技术、医疗资本结盟形成挑战医学伦理的异化力量;确立利益伦理是医学伦理学研究的重要内容;确认患者利益置于首位是现代医学伦理学的首要原则;促进美德伦理与规范伦理结合,推进制度伦理建设与机构伦理建设是医学伦理学落地生根的关键环节。

     

美德伦理学为何不是一个错误的分类范畴

玛莎·努斯鲍姆曾被许多人误以为是美德伦理学家,她本人则声称美德伦理学是一个 “混乱的且令人混乱的”分类范畴,并不存在着美德伦理学这样的事情。然而,她所说的“ 混乱的”美德伦理学范畴是一个过时的、错误的分类范畴。正确的规范伦理学的分类应当是 以研究进路,即以采用何种基本概念作为其理论的逻辑起点来区别其理论类别,如此,正确 的美德伦理学范畴应当是以美德概念作为其理论的基本概念和逻辑起点,而美德概念可以成 为这样的基本概念和逻辑起点。因此,美德伦理学并不是一个错误的分类范畴,它可以是并 且是与功利主义和义务论鼎足而立的三大规范伦理学的研究进路之一。     

也论美德伦理学的基本概念

关于美德伦理学是否具有理论上的独立性,是否可以归于以往规范伦理学(如功利主义美德论、义务论的美德论),哲学界一直存有争论。美德伦理学有自己的基本概念,即各种具体的美德概念。美德伦理学对基本概念以及概念还原主义的应用不是严格欧几里得式的机械应用,而是一种类似关联结构式的概念推理应用。以美德概念为基本概念的美德伦理学具有理论独立性,具有与以往规范伦理学理论抗衡的能力。     

规则伦理的宗教痕迹与美德伦理学

在美德伦理学讨论中,规则伦理学被批评为一种具有律法主义色彩的宗教残留物.在美德伦理看来,规则伦理学残缺地继承了基督教的伦理思维框架,不恰当地理解"规则"的性质却又没有在现代社会中提供充分的依据.因此美德伦理学主张,必须改变规则伦理学的思路,不把"规则"视为某种普遍绝对的律法式条文,而应当看作人们用于处理复杂而不确定的实践问题的资源之一.     

医学伦理教育及其教学法的研究探讨

1　研究源起医学伦理教育在 2 0世纪末期已是医学教育不可缺少的一环 ,其重要性也将因医学与科技的进步而与日俱增。医学教育在过去受Ｆｌｅｘｕｒｅ之理念所主导的训练内容 ,在世界新情势的不断创新下 ,已显然过时有所不足。美国医学协会于 1 970年时即呼吁医学伦理情操的培养在医学训练过程中之重要性。紧接着 ,美加的医学院就把医学伦理有关之议题列为医学教育的课程 ,而哈佛大学也在 1 982年开始对传统医学教育加以检讨 ,并在 1 985年开始“新路径”(ＮｅｗＰａｔｈｗａｙ)的教育改革 ,使医学人文与伦理的强调更上一层楼。台湾在过去一…     

企业伦理的德性主义进路及其条件——以所罗门的亚里士多德方式为例

理解企业伦理的德性主义进路不可或缺。美国当代著名经济伦理学家罗伯特·C．所罗门成功地将亚里士多德德性论引入企业伦理学,为人们把握企业伦理提供了一条德性主义的诠释进路。而亚里士多德德性论强调实践、团体、人对幸福的追求和追求卓越等也为企业伦理的德性主义进路提供了思想资源。而美德自身也能够使人们正确地理解商业和商业伦理、使经济交易成为可能、使经济的运行更为成功。但德性主义进路不是没有条件的,它需要个体或企业具有良好的道德价值观念和良好的判断力,也需要规范伦理与之匹配,以及一个尊重美德的社会环境和相关的制度安排。     

德性伦理论要

德性伦理强调以人类自身的内在品质作为人的一切生活的出发点,这不仅使德性伦理在人类伦理思想的起源处规避着人类伦理生活的方向,而且在现代人类遭遇道德困境的形势下,又指示着人类伦理生活所应该采取的态度。德性伦理最终的理论指向便是将成就德性与明其规范统一起来,从而真正实现人自身的价值。在现代社会价值多元化的背景下,对传统德性伦理资源的挖掘,显得尤为重要。无论是亚里士多德的德性传统,还是原始儒家的德性传统,都可以为现代伦理理论的建设提供丰富的智性资源。     

亚当·斯密美德思想对医务人员德性培养的启示

市场经济下人们对私利的追逐必须要有道德约束,如何帮助医学界走出道德困境是必须直面的理论和现实问题。基于亚当•斯密的美德思想,探讨德性伦理在医务人员德性培养中的重要性。通过审慎、正义、仁慈和克己这四种个人具备的美德,将其与医务人员品行培养实际联系起来,得出在市场经济背景下美德思想对医务人员德性培养的启示,即用审慎之美德提升自身业务能力、用正义之美德维护患者健康利益、用仁慈之美德增进患者幸福感以及用克己之美德学会自我管理等,旨在为医务人员的德性培养提供智识支持以促进医患关系和谐发展。

     

德性伦理与规范伦理在生命伦理中的契合

在生命伦理领域中,规范伦理与德性伦理都曾发挥重要作用,然而,德性伦理没有受到人们足够的重视,重新厘定传统德性伦理的现代价值显得尤为重要。初步探究在生命伦理迅速发展的情况下,德性伦理与规范伦理相结合的模式。     

Virtue as the basis of engineering ethics

This paper explores the nature of virtue theory as applied to engineering practice. It links virtue to specific areas of practice such as the selection of ends, devotion to service, the formation of justified belief, the conduct of dialogue, the taking of actions, and exercises of the will. These areas are related to a culture of virtue in which an engineering society creates the conditions enabling acts of virtue and celebrates individuals and their acts which exemplify identified virtues. The result is a basis for engineering ethics which draws attention to the impetus for an ethically sound life. An earlier version of this paper was presented by the author at a mini-conference, Practicing and Teaching Ethics in Engineering and Computing, held during the Sixth Annual Meeting of the Association for Practical and Professional Ethics, Washington, D.C., March 8–9, 1997.     

Virtue Ethics, The Analects, and the Problem of Commensurability

In support of the thesis that virtue ethics allows for a more comprehensive and consistent interpretation of the Analects than other possible models, the author uses a structural outline of a virtue ethic (derived from Alasdair MacIntyre's account of the Aristotlelian tradition) to organize a discussion of the text. The resulting interpretation focuses attention on the religious aspects of Confucianism and accounts for aspects of the text that are otherwise difficult to explain. In addition, the author argues that the structural similarities between the Aristotelian and Confucian conceptions of self-cultivation indicate a dimension of commensurability between the two traditions, despite very real variations in specific content. Finally, the author suggests how crosscultural commensurability, in general, can be understood on a theoretical level.     

The Limits of Virtue Jurisprudence

In response to Lawrence Solum's advocacy of a 'virtue–centred theory of judging', I argue that there is indeed important work to be done in identifying and characterising those qualities of character that constitute judicial virtues – those qualities that a person needs if she is to judge well (though I criticise Solum's account of one of the five pairs of judicial vices and virtues that he identifies – avarice and temperance). However, Solum's more ambitious claims – that a judge's vice necessarily corrupts her decisions, and that in at least some contexts we must define a legally correct decision as one that would be reached by a virtuous judge – should be rejected: we can undermine the former by attending to the requirements of due process, and the latter by attending to the ways in which a judge would try to justify her decision.     

The Limits of Virtue Jurisprudence

In response to Lawrence Solum's advocacy of a 'virtue–centred theory of judging', I argue that there is indeed important work to be done in identifying and characterising those qualities of character that constitute judicial virtues – those qualities that a person needs if she is to judge well (though I criticise Solum's account of one of the five pairs of judicial vices and virtues that he identifies – avarice and temperance). However, Solum's more ambitious claims – that a judge's vice necessarily corrupts her decisions, and that in at least some contexts we must define a legally correct decision as one that would be reached by a virtuous judge – should be rejected: we can undermine the former by attending to the requirements of due process, and the latter by attending to the ways in which a judge would try to justify her decision.     

Situationism and the problem of moral improvement

A wealth of research in social psychology indicates that various ethically arbitrary situational factors exert a surprisingly powerful influence on moral conduct. Empirically-minded philosophers have argued over the last two decades that this evidence challenges Aristotelian virtue ethics. John Doris, Gilbert Harman, and Maria Merritt have argued that situationist moral psychology – as opposed to Aristotelian moral psychology – is better suited to the practical aim of helping agents act better. The Aristotelian account, with its emphasis on individual factors, invites too much risk of morally bad conduct insofar as it ignores the power of situational factors which lead us astray. Moral agents are often better off detecting and intervening on situational factors to help themselves act better. This paper offers an argument against the claim that situationism enjoys practical advantages over Aristotelian virtue ethics. There is empirical evidence suggesting that people can improve their behavior via Aristotelian strategies of deliberate self-improvement. This evidence also suggests that focusing our ethical attention on morally trivial factors may result in worse overall conduct. Accordingly, Aristotelianism may fare better than situationism on the practical issue of moral improvement.