实现自主的概念:病人的身体在哪些方面有助于医疗决策的自主?

IF 2.3 2区 哲学 Q1 ETHICS Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI:10.1007/s11019-023-10159-7
Jonathan Lewis, Søren Holm
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引用次数: 1

摘要

"身体自主"在生物伦理学、医学伦理学和医学法律中受到了极大的关注,因为病人的身体主权一般不可侵犯,病人有权作出与自己身体有关的选择(例如生殖选择)。然而,身体的作用,就它如何能够或确实有助于病人的能力而言,或在临床决策情况下行使他们的自主权,尚未明确解决。本文中的自主性方法与传统理论相一致,传统理论认为自主性是根据个人的能力和理性反思的练习来构思的。然而,与此同时,本文扩展了这些解释,认为自治在一定程度上是具体化的。具体地说,通过借鉴自主经验的现象学概念,我们认为,原则上,身体是自主能力的必要组成部分。其次,通过两个不同病例的介绍,我们强调了患者的身体可以帮助自主选择治疗的方式。最后,我们希望鼓励其他人探索在医疗决策中应采用具身自主概念的其他条件,其基本原则如何在临床情况下运作,以及其在医疗实践,政策和法律中对患者自主方法的影响。
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Towards a concept of embodied autonomy: In what ways can a patient's body contribute to the autonomy of medical decisions?

"Bodily autonomy" has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient's bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient's capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper is aligned with traditional theories that conceive autonomy in terms of an individual's capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient's body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law.

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来源期刊
CiteScore
4.30
自引率
4.80%
发文量
64
期刊介绍: Medicine, Health Care and Philosophy: A European Journal is the official journal of the European Society for Philosophy of Medicine and Health Care. It provides a forum for international exchange of research data, theories, reports and opinions in bioethics and philosophy of medicine. The journal promotes interdisciplinary studies, and stimulates philosophical analysis centered on a common object of reflection: health care, the human effort to deal with disease, illness, death as well as health, well-being and life. Particular attention is paid to developing contributions from all European countries, and to making accessible scientific work and reports on the practice of health care ethics, from all nations, cultures and language areas in Europe.
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