尊重自主的現象學探討－臨床倫理的主體或他者？

Thesis: Phenomenological Exploration of Respect for Autonomy-The Subject or the Other of Clinical Ethics

王心運(Shin-yun Wang)

《應用倫理評論》 73期 (2022/10) Pp. 69-86

摘要

生命倫理之首要為自主原則，一方面肯定病人具有為自己做最好決定的能力，另一方面要求醫療人員尊重病人判斷，應用「知情同意」的標準程序以達成雙方共識。本文先討論原則主義與關懷倫理學對主體的看法，認為原則主義雖重視主體的權利與義務，但忽略了受苦的主體，而關懷倫理學雖回到關係的親近性，但卻易被批評為過於陷入主觀主義的危險。為了解決上述問題，本文將介紹現象學實效性分析，並引入情境倫理學的說法，以透過加深關懷主義對人的理解，以及擴展原則主義之融貫理論，嘗試以實效性做為融貫理論的計算原則，並做為倫理技術的基礎。

關鍵字

自主原則 ； 原則主義 ； 關懷倫理學 ； 實效性 ； 情境倫理學

並列摘要

The first principle of bioethics is the principle of autonomy. On the one hand, it affirms that the patient can make the best decision for himself. On the other hand, it requires medical personnel to respect the patient's judgment and apply the standard ＂informed consent＂ procedure to reach a mutual consensus. This article will discuss both views of principlism and the caring ethics on the subject, arguing that although principlism attaches importance to the rights and obligations of the subject, it ignores the suffering subject, while caring ethics returns to the intimacy of relationships; however, it is quickly criticized as having the danger to caught up in subjectivism. In order to solve the above problems, this paper will introduce the analysis of phenomenological validity, introduce the argument of situational ethics, deepen the understanding of people by caring, expand the coherence theory of principled, and try to use validity as the coherence theory's main principles to computing the result. The analysis of validity can also serve as the basis for ethical technology.

並列關鍵字

Principle of Autonomy ； Principlism ； Ethics of Care ； Validity ； Ethics of Situation

參考文獻

蔡錚雲，2006，〈情境倫理、現象學心理學與質性研究〉，《哲學與文化》，第三十三卷第二期。

Beauchamp, T.L., Childress, J.F., 2001, Principles of Biomedical Ethics. 5rd Ed., Oxford University Press. 中譯本，李倫等譯，《生命醫學倫理原則》，北京大學出版社，2014。

Fletcher, Joseph, 1997, Situation Ethics : The New Morality Library of Theological Ethics, Westminster John Knox Press. 中譯本，《境遇倫理學》，程立顯譯，中國社會科學出版社，1989。

Held, Virginia. 2006. The Ethics of Care: Personal, Political, and Global. Oxford university press. 中譯本，苑莉均譯，《關懷倫理學》，商務印書館，2014。

Buber, Martin, 2006, I and Thou, trans. by Smith, R. G., Edinburgh.