醫學倫理學之理論與原則

Theories and Principles of Biomedical Ethics

陳映燁(Ying-Yeh Chen) ； 李明濱(Ming-Been Lee)

《Journal of Medical Education》 4卷1期 (2000/03) Pp. 3-22

https://doi.org/10.6145/jme.200003_4(1).0002

摘要

生物醫學科技的急遽發展以及社會的快速變遷使我們面對舆以往截然不同的醫學倫理問題。本文旨在回顧傳統醫學倫理學理論及其臨床應用問題；首先提出醫療過程中倫理衝突之特質，並回顧基本的倫理學理論包括實用論與義務論。本文討論了兩種實用論一行為實用論與原則實用論，並回顧康德、羅斯與羅爾斯之義務論，除了討論理論架構以外，並提出其臨床應用之缺失；進而探討由這些理論所推衍出實際執行醫療時須遵循之原則與規則；最後將倫理學理論與實際醫療情境結合，就醫療基礎條件、道德責任、後果考量與外在考慮四大面向，提供臨床決策的綜合性思考流程，以作為臨床醫師及醫療從業人員之參考。

關鍵字

醫學倫理學 ； 實用論 ； 義務論 ； 臨床決策

並列摘要

As biomedical technology and social changehave developed through the twentieth century,weencounter quite different dilemmas in medical decisions.In the first part of this review,we discuss thecharacteristics of ethical conflicts in clinical practice.Second,we discuss normative medical ethicaltheories including utilitariansim and deontologicaltheory.Two kinds of utilitariansim,act-utilitarianismand rule-utilitarianism,as well as Kantian,Ross's,and Rawls's deontologyare reviewed.In addition to identifying the frameworkof these theories,we also assess the difficultiesof their practical application.A set of principles andrules derived from these theories are discussed foruse in medical practice.A flow-chart to remind theclinician of the range of consideration and eventualdecision making is pressented.This article providesa brief review of biomedical ethics for physiciansand other allied health professionals.(Full text inChinese)

並列關鍵字

biomedical ethics ； utilitarian theory ； deonological theory ； clinical decison