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Policing the Sublime: The Metaphysical Harms of Irreligious Clinical Ethics 监督崇高:非宗教临床伦理学的形而上学危害
Pub Date : 2022-07-07 DOI: 10.1093/cb/cbac005
Kimbell Kornu
Janet Malek has recently argued that the religious worldview of the clinical ethics consultant should play no normative role in clinical ethics consultation. What are the theological implications of a normatively secular clinical ethics? I argue that Malek’s proposal constitutes an irreligious clinical ethics, which commits multiple metaphysical harms. First, I summarize Malek’s key claims for a secular clinical ethics. Second, I explicate both John Milbank’s notion of ontological violence and Timothy Murphy’s irreligious bioethics to show how they apply to Malek’s secular clinical ethics, resulting in an irreligious clinical ethics. Third, I then show how an irreligious clinical ethics commits metaphysical harms to patients, clinical ethics consultants, and the institution of clinical ethics consultation. I conclude that Malek’s proposal for an irreligious clinical ethics must be rejected to maintain the metaphysical integrity of clinical ethics consultants, patients, and the institution of clinical ethics consultation.
Janet Malek最近认为,临床伦理咨询师的宗教世界观不应该在临床伦理咨询中发挥规范作用。规范世俗临床伦理学的神学含义是什么?我认为马利克的提议构成了一种非宗教的临床伦理学,它造成了多重形而上学的危害。首先,我总结了马利克对世俗临床伦理学的主要主张。其次,我解释了约翰·米尔班克的本体论暴力概念和蒂莫西·墨菲的非宗教生命伦理学,以说明它们如何适用于马雷克的世俗临床伦理学,从而导致非宗教的临床伦理学。第三,我将展示一种非宗教的临床伦理是如何对患者、临床伦理顾问和临床伦理咨询制度造成形而上的伤害的。我的结论是,为了维护临床伦理咨询师、患者和临床伦理咨询机构的形而上学完整性,必须拒绝马利克提出的非宗教临床伦理的建议。
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引用次数: 1
There is Room for Encouraging Conversion in the Scope of Bioethics Expertise 在生物伦理学专业知识的范围内有鼓励转换的空间
Pub Date : 2022-07-06 DOI: 10.1093/cb/cbac002
Nathaniel J. Brown
The American Society for Bioethics and Humanities has developed a curriculum leading to a certificate in health care ethics consultation. A certification in ethics consultation initially seems to fit nicely into the biomedical model of clinical expertise espoused by modern biomedicine, but examining what exactly constitutes moral expertise, particularly for traditional Christians, reveals a significant problem: the certification relies on an implicit view of ethics as essentially procedural. It leaves virtually all serious moral content to be filled in, if at all, after an ostensibly neutral scaffolding has been erected. Such an approach does not help answer deep moral questions about how one should live, and it is these questions that ought to be encouraged during some conflicts that result in requests for ethics consultations. This paper suggests that, in certain circumstances, and for a subset of patients, encouraging conversion can help remedy the deficiency of an overly mechanized approach. A system open to conversion would have more room for Traditional Christians, regardless of the outcome, as it would take morality as lived, communal experience more seriously and help others, if desired, to do so as well.
美国生物伦理与人文学会制定了一项课程,可获得保健伦理咨询证书。伦理咨询的认证最初似乎很好地符合现代生物医学所支持的临床专业知识的生物医学模式,但研究道德专业知识的确切构成,特别是对传统基督徒来说,揭示了一个重大问题:认证依赖于一种隐含的观点,即本质上是程序性的伦理。在一个表面中立的脚手架竖立起来之后,几乎所有严肃的道德内容都有待填补,如果有的话。这种方法无助于回答关于人应该如何生活的深层次道德问题,而在一些导致伦理咨询请求的冲突中,这些问题应该得到鼓励。本文认为,在某些情况下,对于一部分患者,鼓励转换可以帮助弥补过度机械化方法的不足。不管结果如何,一个对皈依开放的系统会给传统基督徒更多的空间,因为它会把道德当作生活,更认真地对待公共体验,并在需要时帮助其他人也这样做。
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引用次数: 1
What Does it Mean to be Contrary to Nature? 违背自然意味着什么?
Pub Date : 2022-05-31 DOI: 10.1093/cb/cbac001
David J. Bradshaw
St. Paul says that same-sex sexual acts are “contrary to nature.” Plainly this is intended as a condemnation, but beyond that its meaning is obscure. In particular, we are given no general account of what it means to be contrary to nature, including what other acts might fit this description. This article attempts to provide such an account. It relies for this purpose on the biblical and classical sources of this idiom as well as its subsequent use within the Greek patristic tradition. It argues that the core meaning of “contrary to nature” is that of violating the integrity of structure and function of the human body. The article further contrasts this biblical and Greek patristic understanding with that of the “sin against nature” developed in the West during the Middle Ages. It argues that they are different in important ways and that a recovery of the biblical and Greek patristic view can help restore the concept of the unnatural to its proper place within Christian ethics.
圣保罗说,同性性行为是“违背自然的”。显然,这是一种谴责,但除此之外,它的含义是模糊的。特别是,我们没有得到关于违背自然意味着什么的一般说明,包括其他哪些行为可能符合这一描述。本文试图提供这样一种解释。为了达到这个目的,它依赖于这个成语的圣经和经典来源,以及它随后在希腊教父传统中的使用。认为“违背自然”的核心含义是违背人体结构和功能的完整性。文章进一步将这种圣经和希腊教父的理解与中世纪西方发展起来的“违背自然之罪”的理解进行了对比。它认为它们在重要的方面是不同的,恢复圣经和希腊教父的观点可以帮助将非自然的概念恢复到基督教伦理的适当位置。
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引用次数: 1
Brain Death, the Soul, and Material Dispositions 脑死亡、灵魂和物质处置
Pub Date : 2022-03-18 DOI: 10.1093/cb/cbab018
Patrick Lee
I defend the position argued previously by Germain Grisez and me that total brain death is a valid criterion of death on the grounds that a human being is essentially a rational animal, and a brain-dead body lacks the radical capacity for rational actions. I reply to Josef Seifert’s objection that our positions rest on a reductionist view of the human person, and to other objections concerning the inter-relation between the human soul, its powers, and functions of the brain. I argue that a brain-dead body lacks the material dispositions needed for having the form or soul of a human being.
我捍卫Germain Grisez和我之前提出的观点,即完全脑死亡是一个有效的死亡标准,因为人类本质上是一种理性动物,脑死亡的身体缺乏理性行为的根本能力。我对Josef Seifert的反对意见,即我们的立场建立在对人的简化论观点上,以及其他关于人类灵魂、它的力量和大脑功能之间的相互关系的反对意见,做出回应。我认为脑死亡的身体缺乏具有人的形式或灵魂所需要的物质倾向。
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引用次数: 1
Enhancing the Imago Dei: Can a Christian Be a Transhumanist? 强化上帝意象:基督徒能成为超人类主义者吗?
Pub Date : 2022-01-14 DOI: 10.1093/cb/cbab016
J. Eberl
Transhumanism is an ideology that embraces the use of various forms of biotechnology to enhance human beings toward the emergence of a “posthuman” kind. In this article, I contrast some of the foundational tenets of Transhumanism with those of Christianity, primarily focusing on their respective anthropologies—that is, their diverse understandings of whether there is an essential nature shared by all human persons and, if so, whether certain features of human nature may be intentionally altered in ways that contribute toward how each views human flourishing. A central point of difference concerns Transhumanists’ aim of attaining “substrate independence” for the human mind, such that one’s consciousness could be uploaded into a cybernetic environment. Christian anthropology, on the other hand, considers embodiment, with its characteristics of vulnerability and finitude, to be an essential feature of human nature—hence, Christians’ belief in bodily resurrection. Despite Christianity and Transhumanism having fundamental differences, I contend that Christians may support moderate forms of enhancement oriented toward supporting our flourishing as living, sentient, social, and rational animals.
超人类主义是一种意识形态,它包括使用各种形式的生物技术来增强人类走向“后人类”的出现。在这篇文章中,我对比了超人类主义和基督教的一些基本原则,主要集中在他们各自的人类学上——也就是说,他们对是否存在所有人都共有的本质的不同理解,如果有,人性的某些特征是否可以被有意地改变,以有助于每个人如何看待人类繁荣。超人类主义者的一个中心差异在于,他们的目标是实现人类思想的“基底独立性”,这样一个人的意识就可以被上传到控制论环境中。另一方面,基督教人类学认为具有脆弱性和有限性的化身是人性的本质特征——因此,基督徒相信身体复活。尽管基督教和超人类主义有着根本的不同,但我认为基督徒可能会支持适度的增强形式,以支持我们作为有生命的、有感情的、社会的和理性的动物的繁荣。
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引用次数: 3
Physician-Assisted Suicide and Euthanasia: Theological and Ethical Responses 医生协助自杀和安乐死:神学和伦理回应
Pub Date : 2021-12-01 DOI: 10.1093/cb/cbab015
D. Sulmasy
Euthanasia and rational suicide were acceptable practices in some quarters in antiquity. These practices all but disappeared as Hippocratic, Jewish, Christian, and Muslim beliefs took hold in Europe and the Near East. By the late nineteenth century, however, a political movement to legalize euthanasia and physician-assisted suicide (PAS) began in Europe and the United States. Initially, the path to legalization was filled with obstacles, especially in the United States. In the last few decades, however, several Western nations have legalized euthanasia, and several US jurisdictions have now legalized PAS, giving state sanction to these once forbidden practices. With increasing social and political pressure to accept PAS, Christians need to understand how to think about this issue from an explicitly Christian perspective. Independent of the question of legalization, there are significant theological and ethical questions. This special issue aims to address those concerns, including: how does the practice of PAS or euthanasia impact our attitudes toward death, and what does it mean to “die well?” Should physicians, as healers, be involved in assisting patients who wish to bring about their own death? Are these methods significantly distinguished from other ethically justified practices in end-of-life care that also lead to a person’s death? Can Christians, both as patients and practitioners, justify the use of these methods to relieve suffering in this manner as compatible with the faith? Although these questions are not new to the debate, it is increasingly important that these controversies are addressed as the practice of PAS is popularized.
在古代,安乐死和理性自杀在某些地方是可以接受的。随着希波克拉底、犹太教、基督教和穆斯林信仰在欧洲和近东扎根,这些做法几乎消失了。然而,到了19世纪晚期,一场要求安乐死和医生协助自杀合法化的政治运动在欧洲和美国开始了。最初,大麻合法化的道路充满了障碍,尤其是在美国。然而,在过去的几十年里,一些西方国家已经将安乐死合法化,一些美国司法管辖区现在已经将PAS合法化,给予这些曾经被禁止的做法国家制裁。随着接受PAS的社会和政治压力的增加,基督徒需要了解如何从明确的基督教角度来思考这个问题。除了合法化问题之外,还有重要的神学和伦理问题。本期特刊旨在解决这些问题,包括:PAS或安乐死的做法如何影响我们对死亡的态度,以及“死得好”意味着什么?作为治疗者,医生是否应该参与帮助那些希望结束自己生命的病人?这些方法与其他在道德上合理的临终关怀中也会导致一个人死亡的做法有显著区别吗?基督徒,无论是作为病人还是作为从业者,都能证明使用这些方法来减轻痛苦是符合信仰的吗?虽然这些问题在辩论中并不新鲜,但随着PAS实践的普及,这些争议得到解决变得越来越重要。
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引用次数: 0
Understanding the Voices of Disability Advocates in Physician-Assisted Suicide Debates 理解医生协助自杀辩论中残疾人倡导者的声音
Pub Date : 2021-12-01 DOI: 10.1093/cb/cbab011
D. Stahl
Christians have an obligation to attend to the voices of persons who are crying out that their dignity and very lives are in jeopardy when physician-assisted suicide (PAS) becomes legalized. The following essay begins with an account of the concept of “disability moral psychology,” which elucidates the unique ways persons with disabilities perceive the world, based on their phenomenological experience. The author then explores the disability critique of PAS and the shared social conditions of persons who are chronically disabled and terminally ill. Finally, the author positions the disability critique within Christian moral deliberations on PAS to unearth its significance for Christian ethics. To bear witness to a compassionate God, theological and ethical judgments concerning PAS must seek perspectives from persons who claim that their dignity and even their lives are in jeopardy by the practice.
当医生协助自杀(PAS)合法化后,人们的尊严和生命都受到了威胁,基督徒有义务去倾听这些人的呼声。下面这篇文章首先阐述了“残疾道德心理学”的概念,它阐明了残疾人基于现象学经验感知世界的独特方式。然后,作者探讨了PAS的残疾批评以及长期残疾和绝症患者的共同社会状况。最后,笔者将残障批判置于基督教对PAS的道德思考之中,以揭示其对基督教伦理的意义。为了见证一位慈悲的上帝,关于考绩制度的神学和伦理判断必须寻求那些声称他们的尊严甚至生命因考绩制度而受到威胁的人的观点。
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引用次数: 2
Dying under a Description? Physician-Assisted Suicide, Persons, and Solidarity 死在描述下?医生协助自杀,个人和团结
Pub Date : 2021-12-01 DOI: 10.1093/cb/cbab014
Darlene Fozard Weaver
Debates over physician-assisted suicide (PAS) comprise a small portion of broader culture wars. Their role in the culture wars obscures an under-acknowledged consensus between those who support PAS and those who oppose it. Drawing insights from personalism, this essay situates PAS within larger moral obligations of solidarity with the dying and their caregivers. The contributions of Roman Catholic personalism relocate debates over PAS and allow us to harness shared moral impulses.
关于医生协助自杀(PAS)的争论只是更广泛的文化战争的一小部分。他们在文化战争中的角色掩盖了支持PAS和反对PAS的人之间未被承认的共识。从个人主义的见解,这篇文章定位PAS在更大的道德义务团结与死亡和他们的照顾者。罗马天主教个人主义的贡献重新定位了对PAS的争论,并使我们能够驾驭共同的道德冲动。
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引用次数: 0
Killing and Allowing to Die: Insights from Augustine 杀戮与允许死亡:奥古斯丁的见解
Pub Date : 2021-11-10 DOI: 10.1093/cb/cbab013
D. Sulmasy
One major argument against prohibiting euthanasia and physician-assisted suicide (PAS) is that there is no rational basis for distinguishing between killing and allowing to die: if we permit patients to die by forgoing life-sustaining treatments, then we also ought to permit euthanasia and PAS. In this paper, the author argues, contra this claim, that it is in fact coherent to differentiate between killing and allowing to die. To develop this argument, the author provides an analysis of Saint Augustine’s distinction between martyrdom and suicide, highlighting the relevance of intention in the assessment of an agent’s actions. As a general matter of ethics, the intentions of agents, not just the outcomes of their actions, matter enormously for drawing distinctions between what is permissible and what is impermissible. Constructing an Augustinian account of this distinction between killing and allowing to die, the author argues that it is coherent to hold that assisted suicide is wrong, while also accepting that it is permissible to withhold or withdraw life-sustaining treatments.
反对禁止安乐死和医生协助自杀(PAS)的一个主要论点是,没有合理的基础来区分杀人和允许死亡:如果我们允许病人通过放弃维持生命的治疗而死亡,那么我们也应该允许安乐死和PAS。在本文中,作者反驳了这一说法,认为区分杀人和允许死亡实际上是一致的。为了展开这一论点,作者分析了圣奥古斯丁对殉道和自杀的区别,强调了评估行为人行为时意图的相关性。作为一个普遍的伦理问题,行为主体的意图,而不仅仅是他们行为的结果,对于区分什么是允许的,什么是不允许的有着巨大的影响。作者构建了一个奥古斯丁式的关于杀人和允许死亡之间区别的解释,认为协助自杀是错误的,同时也接受了允许保留或撤回维持生命的治疗,这是一致的。
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引用次数: 1
Incarnation, Posthumanism and Performative Anthropology: The Body of Technology and the Body of Christ 化身、后人类主义与行为人类学:技术的身体与基督的身体
Pub Date : 2021-07-14 DOI: 10.1093/cb/cbab009
M. Burdett
This essay argues that a Christian incarnational response to posthumanism must recognize that what is at stake isn't just whether belief systems align. It seeks to relocate the interaction between the church and posthumanism to how the practices of posthumanism and Christianity perform the bodies, affections and dispositions of each. Posthuman practices seeks to habituate: (1) A preference for informational patterns over material instantiation; (2) that consciousness and the self are extended and displaced rather than discrete and localized; (3) that the body is merely a tool, the original prosthesis we learn to manipulate and (4) that human life is organized such that it is seamless with intelligent machines. The Christian performance of embodied life, on the other hand, has Christ as template and, in the Eucharist, Christians are marked by offering, sacrifice and celebration in a community that affirms the integrity of our common incarnate life.
这篇文章认为,基督教对后人类主义的化身反应必须认识到,关键不仅仅是信仰体系是否一致。它试图重新定位教会和后人文主义之间的互动,以了解后人文主义和基督教的实践如何表现各自的身体,情感和性情。后人类实践试图习惯于:(1)对信息模式的偏好高于物质实例化;(2)意识和自我是延伸的和移位的,而不是离散的和局部的;(3)身体仅仅是一种工具,是我们学会如何操纵的原始假肢;(4)人类的生命是与智能机器紧密相连的。另一方面,基督徒的具体生活表现以基督为模板,在圣餐中,基督徒在一个肯定我们共同的化身生命的完整性的团体中以奉献、牺牲和庆祝为标志。
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引用次数: 1
期刊
Christian bioethics: Non-Ecumenical Studies in Medical Morality
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