生命倫理四原則方法

The Four Principles Approach to Bioethics

蔡甫昌(Daniel Fu-Chang Tsai)

《Journal of Medical Education》 4卷2期 (2000/06) Pp. 140-154

https://doi.org/10.6145/jme.200006_4(2).0003

摘要

生命倫理四原則方法自1979年在美國為TomL. Beauchamp及James F. Childress所提出後逐漸發展成一有系統之應用倫理學理論，並在北美普遍地爲醫學倫理教育及臨床討論沿用，成爲許多專科醫學會之倫理守則；另一方面也遭受哲學家及生命倫理學家的激烈批評及辯論，而此生命倫理學方法是否能被廣泛而有效地應用到不同的文化及社會，也是一爭論的焦點。本文由當代生命倫理歷史事件之回顧進而介紹生命倫理四原則方法之理論架構包括：以「道德原則」為基礎之「共有道德理論」、四初確原則(prima facie principles)即尊重自主原則(respect for autonomy)、不傷害原則(nonmaleficence)、行善原則(beneficence)、正義原則(justice)，連貫法論證(coherentism)、特定化法(specification)、平衡及淩駕法(balancing and overriding)等，幷討論其所受到之批評及理論作者之回應與辯護，最後提出對該方法的三點評論。

關鍵字

醫學倫理 ； 生命倫理 ； 四原則方法

並列摘要

The four principles approach to bioethics (autonomy, beneficence, nonmaleficence and justice) has been developed by Beauchamp and Childress since1979, and has been increasingly used in medical ethical education and practice in the USA. For the past two decades, after undergoing a great deal of criticisms and debates, and through the revision of the four editions of their works-Principles of Biomedical Ethics (PBE) -the theories of 'the four-principles approach to bioethics were constructed to become more comprehensive and systematic. Starting with a brief review of the history of modern bioethics, this article introduces the theoretical framework of the Four principles approach to bioethics' including the principle-based, common morality theory', 'four prima facie principles: respect for autonomy, beneficence, nonmaleficence, and justice', 'coherentism', 'specification', and 'balancing and overriding', and then discusses the criticism it has received and the defence and refutation it has responded. Finally, the author proposes three comments on the theory and practice of this bioethics method.

並列關鍵字

medical ethics ； bioethics ； four-principles aproach