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Christian bioethics: Non-Ecumenical Studies in Medical Morality最新文献

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Indexing Burdens and Benefits of Treatment to Age: Revisiting Paul Ramsey’s “Medical Indications” Policy 索引负担和利益的治疗年龄:重新审视保罗·拉姆齐的“医学指征”政策
Pub Date : 2021-07-05 DOI: 10.1093/CB/CBAB003
M. Anderson
This essay reconsiders Paul Ramsey’s “medical indications” policy and argues that his reconstruction of the case of Joseph Saikewicz demonstrates that there is more room for caretakers to decline treatments for “voiceless dependents” than his interlocutors have sometimes thought. It furthermore draws on Ramsey’s earlier work to propose ways that Ramsey might have improved his policy, and argues that the shortcomings of Ramsey’s view arise from his bracketing of age in making determinations about what form of medical care is owed. The reading of Ramsey set forth here suggests Cathleen Kaveny’s depiction of the ‘medical indications’ policy in Ethics at the Edges of Law is too rigid and inflexible, even while it affirms other aspects of her critique.
本文重新考虑了保罗·拉姆齐的“医学指证”政策,并认为他对约瑟夫·塞克维茨案例的重建表明,对于那些拒绝接受“无法发声的家属”治疗的看护人来说,他们的空间比他的对话者有时想象的要大。它进一步借鉴了拉姆齐早期的工作,提出了拉姆齐可能改进他的政策的方法,并认为拉姆齐观点的缺点源于他在决定何种形式的医疗保健时将年龄划分在一个范围内。本文对拉姆齐的解读表明,凯瑟琳·卡维尼在《法律边缘的伦理学》中对“医学指征”政策的描述过于僵化和不灵活,尽管它肯定了她批评的其他方面。
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引用次数: 1
Christian Bioethics and the Partisan Commitments of Secular Bioethicists: Epistemic Injustice, Moral Distress, Civil Disobedience 基督教生命伦理学与世俗生命伦理学家的党派承诺:认识上的不公正、道德困境、公民不服从
Pub Date : 2021-07-05 DOI: 10.1093/CB/CBAB005
M. Cherry
Secular bioethicists do not speak from a place of distinction, but from within particular culturally, socially, and historically conditioned standpoints. As partisans of moral and ideological agendas, they bring their own biases, prejudices, and worldviews to their roles as ethical consultants, social advocates, and academics, attempting rhetorically to sway others and shift policy to a preferred point of view. Their pronouncements represent just one voice among others, even when delivered with strident rhetoric, in an educated and knowing tone, from within institutional positions of power. This essay argues that, given the hegemony of progressive secular bioethics, traditional Christians routinely face epistemic injustice within medicine. That is, Christian knowledge regarding moral reality is all too often demeaned or dismissed, unless such norms can be translated into and defended within a secular ethos. Given such systemic bias, I argue, Christians also experience significant moral distress: they are fully aware of their moral obligations and what they ought to do, but institutionalized power structures make it nearly impossible to so act. But, Christian physicians are not mere technicians, obliged to provide whatever patients request from the list of legally available treatments. That antireligious critics seek to remove the rights of Christian physicians to limit how they practice medicine, where they do not offer or refer for abortion, euthanasia, physician-assisted suicide, and other inappropriate forms of care, is unjustified and prejudicial, singling out Christians, and other religious groups, for singular treatment. Regardless of what the law requires or institutional policy demands, however, Christians are obliged to submit to God in all things. As a result, they may at times find themselves required to engage in acts of civil disobedience.
世俗的生命伦理学家不是站在一个特殊的地方,而是站在特定的文化、社会和历史条件的立场上说话。作为道德和意识形态议程的拥护者,他们把自己的偏见、偏见和世界观带到他们作为道德顾问、社会倡导者和学者的角色中,试图用修辞来影响他人,将政策转向自己喜欢的观点。他们的声明只代表了众多声音中的一种,即使是在以受过教育和知情的语气发表的尖锐言辞中,也是来自权力机构的。本文认为,鉴于进步的世俗生命伦理学的霸权,传统的基督徒在医学中经常面临认识上的不公正。也就是说,基督教关于道德现实的知识经常被贬低或忽视,除非这些规范可以转化为世俗精神并在其内部得到捍卫。我认为,鉴于这种系统性偏见,基督徒也会经历重大的道德困境:他们完全意识到自己的道德义务和应该做什么,但制度化的权力结构使他们几乎不可能这样做。但是,基督教医生不仅仅是技术人员,有义务从合法可用的治疗方法列表中提供任何患者要求的治疗方法。那些反宗教的批评者试图剥夺基督教医生的权利,限制他们如何行医,在那里他们不能提供或推荐堕胎、安乐死、医生协助自杀和其他不适当的护理形式,这是不公正和偏见的,他们把基督徒和其他宗教团体单独挑出来,接受单一治疗。然而,无论法律要求或制度政策要求如何,基督徒都有义务在一切事情上顺服神。因此,他们有时可能会发现自己需要参与公民不服从的行动。
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引用次数: 0
Is Pregnancy Really a Good Samaritan Act? 怀孕真的是一个见义勇为的行为吗?
Pub Date : 2021-07-05 DOI: 10.1093/CB/CBAB004
B. Blackshaw
One of the most influential philosophical arguments in favor of the permissibility of abortion is Judith Jarvis Thomson’s violinist analogy, presented in “A Defense of Abortion.” Its appeal for prochoice advocates lies in Thomson’s granting that the fetus is a person with equivalent moral status to any other human being, and yet demonstrating—to those who accept her reasoning—that abortion is still permissible. In her argument, Thomson draws heavily on the parable of the Good Samaritan, arguing that gestating a fetus in some circumstances is what she calls a Good Samaritan act, and claiming that we are not morally required to be Good Samaritans. Here, I argue that Thomson has subverted the parable to justify an action that is the antithesis of its meaning. I contend that Christians are required to be Good Samaritans, and explain that for Christians, this entails that abortion is impermissible in all circumstances. Furthermore, I argue that the parable shows that the fetus is our neighbor in need of our mercy and assistance, and consequently, Christians should be actively involved in helping to ensure the unborn are protected, whether they are fetuses in danger of induced abortion or miscarriage, or surplus frozen embryos.
支持允许堕胎的最具影响力的哲学论点之一是朱迪思·贾维斯·汤姆森(Judith Jarvis Thomson)在《为堕胎辩护》(A Defense of abortion)中提出的小提琴家类比。它对赞成堕胎的人的吸引力在于,汤姆逊承认胎儿是一个与其他人具有同等道德地位的人,但对那些接受她的推理的人来说,堕胎仍然是允许的。在她的论证中,汤姆森大量引用了好撒玛利亚人的寓言,认为在某些情况下怀孕是她所说的好撒玛利亚人的行为,并声称我们在道德上不需要成为好撒玛利亚人。在这里,我认为汤姆逊颠覆了这个寓言,为一个与其意义相反的行为辩护。我主张基督徒必须成为好撒玛利亚人,并解释说,对基督徒来说,这意味着堕胎在任何情况下都是不允许的。此外,我认为这个寓言表明,胎儿是我们的邻居,需要我们的怜悯和帮助,因此,基督徒应该积极参与帮助确保未出生的胎儿受到保护,无论他们是处于人工流产或流产危险中的胎儿,还是多余的冷冻胚胎。
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引用次数: 4
Deontic Fallacies and the Arguments against Conscientious Objections 道义谬误和反对良心异议的论证
Pub Date : 2021-07-05 DOI: 10.1093/CB/CBAB007
S. Napier
The respect for one’s conscience is rooted in a broader respect for the human person. The conscience represents a person’s ability to identify the values and goods that inform her moral identity. Ignoring or overriding a person’s conscience can lead to significant moral and emotional distress. Refusals to respect a person’s conscientious objection to cases of killing are a source of incisive distress, since judgments that it is impermissible to kill so-and-so are typically held very strongly and serve as central moral commitments in one’s moral identity. I think it is wrong for a college basketball coach to pay his players, but I think it is really wrong to kill people. This article argues that any and all arguments for not respecting a conscientious objection to abortion commit a deontic fallacy. Briefly, arguments for the permissibility of abortion are structurally such that abortion is at best permissible, not obligatory. Now, arguments to justify overriding or ignoring a person’s objection to performing action (α) must understand action (α) as being obligatory. Thus, arguments for ignoring conscientious objections to performing abortion are incongruent with the actual philosophical justifications for abortion. Such arguments, then, commit a deontic fallacy.
对良心的尊重源于对人的更广泛的尊重。良心代表了一个人识别价值和商品的能力,这些价值和商品构成了她的道德身份。忽视或压倒一个人的良心会导致严重的道德和情感上的痛苦。拒绝尊重一个人对杀戮的良心反对是一种深刻的痛苦的来源,因为杀人是不允许的判断通常是非常强烈的,并且是一个人道德身份的核心道德承诺。我认为大学篮球教练付钱给他的球员是不对的,但我认为杀人确实是不对的。本文认为,任何和所有不尊重良心反对堕胎的论点都犯了道义谬误。简而言之,允许堕胎的论点在结构上是这样的,堕胎充其量是允许的,而不是强制性的。现在,论证推翻或忽视一个人对执行行动(α)的反对必须理解行动(α)是强制性的。因此,无视良心反对堕胎的论点与堕胎的实际哲学理由是不一致的。这样的论证犯了道义谬误。
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引用次数: 1
Confessional Approach to Disclosure of Medical Error 医疗差错披露的忏悔途径
Pub Date : 2021-06-08 DOI: 10.1093/CB/CBAB006
J. Mason
Recent literature on the ethics of medical error disclosure acknowledges the feelings of injustice, confusion, and grief patients and their families experience as a result of medical error. Substantially less literature acknowledges the emotional and relational discomfort of the physicians responsible or suggests a meaningful way forward. To address these concerns more fully, I propose a model of medical error disclosure that mirrors the theological and sacramental technique of confession. I use Aquinas’ description of moral acts to show that all medical errors are evil, and some accidental medical errors constitute venial sins; all sin and evil should be confessed. As Aquinas urges confession for sins, here I argue that confession is necessary to restore physicians to the community and to provide a sense of absolution. Even mistakes for which physicians are not morally culpable ought to be confessed in order to heal the physician–patient relationship and to address feelings of professional distress. This paper utilizes an Episcopal theology of confession that affirms verbal admission and responsibility-taking as freeing and relationally restoring acts, arguing that a confessional stance toward medical error both leads to better outcomes in physician–patient relationships and is more compassionate toward physicians who err.
最近关于医疗差错披露伦理的文献承认,由于医疗差错,患者及其家属经历了不公正、困惑和悲伤的感觉。很少有文献承认医生的情感和关系上的不适,或者建议有意义的前进道路。为了更充分地解决这些问题,我提出了一个反映忏悔的神学和圣礼技术的医疗错误披露模型。我用阿奎那对道德行为的描述来表明,所有的医疗错误都是邪恶的,一些意外的医疗错误构成了可赦免的罪;所有的罪恶和邪恶都应该忏悔。正如阿奎那敦促为罪忏悔,在这里我认为忏悔是必要的,以恢复医生的社会,并提供一种赦免的感觉。即使是医生在道德上没有责任的错误,也应该承认,以治愈医患关系,解决职业上的痛苦。这篇论文运用了圣公会的忏悔神学,它肯定了口头承认和承担责任是一种自由和关系恢复的行为,认为对医疗错误的忏悔立场既能在医患关系中带来更好的结果,也对犯错的医生更有同情心。
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引用次数: 1
Opposing Vitalism and Embracing Hospice: How a Theology of the Sabbath Can Inform End-of-Life Care 反对活力论,拥抱临终关怀:安息日神学如何影响临终关怀
Pub Date : 2021-05-29 DOI: 10.1093/CB/CBAB008
Sarah K Sawicki
Medicine often views hospice care as “giving up,” which results in a reduced quality of end-of-life care for many patients. By integrating a theology of the Sabbath with modern medicine, hospice becomes a sacred and valuable way to honor the dying patient in a comprehensive and holistic way. A theology of Sabbath as “Sacredness in Time” can provide the foundation for a shift in understanding hospice as a legitimate care plan, which shifts the focus from controlling and manipulating space for the body, to rest and enjoyment of time for the whole person. First, I explore vitalism and its negative effects on the institution of hospice. Second, I address the main misconceptions and biases surrounding hospice in order to establish hospice as an appropriate option for the terminally ill. Finally, I argue for a shift away from sacredness in space (as seen in vitalism) to sacredness in time.
医学通常将临终关怀视为“放弃”,这导致许多患者的临终关怀质量下降。通过将安息日神学与现代医学相结合,临终关怀成为一种神圣而有价值的方式,以一种全面而整体的方式来尊重垂死的病人。安息日的神学作为“时间的神圣性”可以为理解临终关怀作为一种合法的护理计划提供基础,它将焦点从控制和操纵身体的空间转移到整个人的休息和享受时间。首先,我探讨活力论及其对安宁疗护制度的负面影响。其次,我解决围绕安宁疗护的主要误解和偏见,以建立安宁疗护作为绝症患者的适当选择。最后,我主张从空间的神圣性(如生机论所见)转向时间的神圣性。
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引用次数: 1
Christian Bioethics: Reflections on a Quarter-Century with the Journal 基督教生命伦理学:四分之一世纪以来对期刊的反思
Pub Date : 2021-05-29 DOI: 10.1093/CB/CBAB002
B. Lustig
This essay reflects on 25 years since Christian Bioethics began publication and, in somewhat autobiographical fashion, engages two core concerns. First, although “non-ecumenism” may often appear a pretext for contention and division, I suggest that a respectful non-ecumenism may provide the opportunity for dialogue and the occasion for employing certain tools from religious studies. Second, although many are skeptical about the possibilities of identifying a “common morality,” a defense of that notion provides a plausible explanation for the development of limited consensus on some issues in bioethics.
这篇文章回顾了基督教生命伦理学出版以来的25年,并以某种自传体的方式,涉及两个核心问题。首先,尽管“非大公主义”可能经常成为争论和分裂的借口,但我认为,尊重的非大公主义可能为对话提供机会,并为使用宗教研究中的某些工具提供场合。其次,尽管许多人对确定“共同道德”的可能性持怀疑态度,但对这一概念的辩护为生物伦理学中某些问题上有限共识的发展提供了一个合理的解释。
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引用次数: 1
Desmond Tutu, George Carey and the Legalization of Euthanasia: A Response 德斯蒙德·图图、乔治·凯里与安乐死合法化:回应
Pub Date : 2021-05-25 DOI: 10.1093/CB/CBAB001
J. Keown
When two Christian prelates as internationally prominent as Desmond Tutu and George Carey call for the legalization of euthanasia and physician-assisted suicide, their arguments merit close consideration. This article sets out and evaluates their arguments. It concludes that the prelates rehearse the superficial case regularly advanced by euthanasia campaigners and fail adequately to engage with the arguments, both principled and practical, against legalization.
当德斯蒙德·图图(Desmond Tutu)和乔治·凯里(George Carey)这两位国际知名的基督教高级教士呼吁安乐死和医生协助自杀合法化时,他们的观点值得仔细考虑。本文列出并评价了他们的观点。它的结论是,主教们经常排练安乐死运动者提出的肤浅案例,未能充分参与反对合法化的原则和实践论点。
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引用次数: 1
Visions of the Common Good: Engelhardt’s Engagement with Catholic Social Teaching 共同利益的愿景:恩格尔哈特对天主教社会教学的参与
Pub Date : 2021-03-13 DOI: 10.1093/CB/CBAA019
J. Eberl
In this paper, I confront Engelhardt’s views—conceptualized as a cohesive moral perspective grounded in a combination of secular and Christian moral requirements—on two fronts. First, I critique his view of the moral demands of justice within a secular pluralistic society by showing how Thomistic natural law theory provides a content-full theory of human flourishing that is rationally articulable and defensible as a canonical vision of the good, even if it is not universally recognized as such. Second, I defend the principles of Roman Catholic social teaching (RCST) against Engelhardt’s objection that it constitutes a watered-down version of the Christian moral vision which opens the door to intolerable moral compromises. While I acknowledge that Engelhardt’s criticism of RCST is well-grounded in certain abusive compromises that have been made by some Catholic healthcare institutions, I contend that such abuses are not endemic to RCST and avoidance of them is practically feasible in contemporary secular pluralistic societies. My primary aim is to show how continued dialogue between Engelhardtian libertarians and more communitarian-inclined RCST proponents may constructively yield a vision of healthcare allocation that ensures succor for the least advantaged within an authentically Christian social ethic.
在本文中,我从两个方面对恩格尔哈特的观点进行了探讨。恩格尔哈特的观点被概念化为一种建立在世俗和基督教道德要求结合基础上的有凝聚力的道德观点。首先,我通过展示托马斯的自然法则理论如何提供了一个内容丰富的人类繁荣理论来批判他对世俗多元社会中正义的道德要求的观点,这个理论作为一种规范的善的愿景是合理的,可辩护的,即使它没有被普遍认可。其次,我捍卫罗马天主教社会教导(RCST)的原则,反对恩格尔哈特(Engelhardt)的反对意见,即它构成了基督教道德愿景的淡化版本,为不可容忍的道德妥协打开了大门。虽然我承认恩格尔哈特对RCST的批评是基于一些天主教医疗机构做出的某些滥用妥协,但我认为这种滥用并不是RCST特有的,在当代世俗多元社会中避免它们实际上是可行的。我的主要目的是展示恩格尔哈德式的自由意志主义者和更倾向于社区主义的RCST支持者之间的持续对话,如何建设性地产生一种医疗分配的愿景,确保在真正的基督教社会伦理中为最弱势群体提供援助。
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引用次数: 1
The Doctor–Patient Relationship: Does Christianity Make a Difference? 医患关系:基督教有影响吗?
Pub Date : 2021-03-13 DOI: 10.1093/CB/CBAA018
J. Delaney
The nature of the doctor–patient relationship is central to the practice of medicine and thus to bioethics. The American Medical Association (in AMA principles of medical ethics, available at: https://www.ama-assn.org/delivering-care/ethics/patient-physician-relationships, 2016) states, “The practice of medicine, and its embodiment in the clinical encounter between a patient and a physician, is fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering.” In this issue of Christian Bioethics, leading scholars consider what relevance (if any) Christianity brings to the relationship between physician and patient: does Christianity make a difference? The contributors consider this question from several different perspectives: the proper model of medicine, the role that the Christian moral tradition can play in medicine in a secular pluralistic society, how a Christian understanding of virtue can inform practices such as perinatal hospice and physician-assisted suicide, and whether or not appeals to Christian values can (or should) ground a physician’s right to conscientious objection.
医患关系的本质是医学实践的核心,因此也是生物伦理学的核心。美国医学协会(在AMA医学伦理原则中,可在:https://www.ama-assn.org/delivering-care/ethics/patient-physician-relationships, 2016)指出,“医学实践及其在病人和医生之间的临床接触中的体现,从根本上说是一种道德活动,源于照顾病人和减轻痛苦的必要性。”在本期的《基督教生命伦理学》中,主要学者们考虑了基督教给医患关系带来的相关性(如果有的话):基督教有影响吗?作者从几个不同的角度来考虑这个问题:医学的正确模式,基督教道德传统在世俗多元化社会中在医学中所扮演的角色,基督教对美德的理解如何能够为围产期临终关怀和医生协助自杀等实践提供信息,以及是否呼吁基督教价值观可以(或应该)为医生的良心反对权提供基础。
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引用次数: 0
期刊
Christian bioethics: Non-Ecumenical Studies in Medical Morality
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