The Autonomous Person: An Essay on Pellegrino-Thomasma's Understanding of Autonomy and Person

有自主權的人：關於派樂哥利諾及托馬斯馬所理解的自主與個人的論文

于柏桂(Victor Carlos C. Yparraguirre)

《全人教育學報》 10期 (2012/07) Pp. 1-43

https://doi.org/10.6272/JHE.2012.10.1

摘要

本篇論文是以作者愛德蒙德‧派樂哥利諾（醫師），及大衛‧托馬斯馬（哲學博士）兩位對具有位格人的屬性的理解進行討論。在本文中將特別強調關於“醫學與哲學之間的關係”、“哲學與醫學”、“醫學中的哲學”以及最後“醫學本身的哲學”等各方面加以闡述。臨床的互動就是一種哲學與醫學關係的獨特體驗，從臨床的互動，我們可以看見醫學和哲學之間逐漸清楚的人類學。這種人類學顯然以對獨立自主的人的了解為文本；而病人，亦即臨床互動的焦點，是自主與人性的出發點。病人，雖然他承受著病痛的煎熬，但還是臨床互動中有主動能力的主體。一個有自主權的人是一個可以為自己，也為自己的社群做出好的和對的決定的人，雖然他有病痛造成的軟弱；雖然他的利益會跟族群的利益有所衝突，但他並不理所當然地得屈服於他的自主權；相反的，他更被要求運用智慧來提升自己和社群的利益。

關鍵字

自主權 ； 臨床互動 ； 人類學 ； 醫學 ； 哲學 ； 生命倫理學 ； 醫學倫理學 ； 個人＜人格位格＞

並列摘要

This essay presents a particular understanding of an autonomous person according to Edmund D. Pellegrino, MD and David C. Thomasma, Ph.D. It follows the contours of the discussion outlined by our authors, specifically highlighting the relationship between medicine and philosophy. Philosophy and medicine, philosophy in medicine, and finally, philosophy of medicine are the modalities where this relationship finds expressions.The clinical encounter is the singular instance wherein this relationship between philosophy and medicine is played out. It is from this clinical situation where an anthropology workable for both medicine and philosophy gradually emerges.This emergent anthropology is the context wherein the concepts of autonomy and person are crystallized. The patient, who is the focus of the clinical encounter, is the subject from which autonomy and person are distilled. The patient, impaired though he is by illness, is still a subject who is an active partner in the activities during the clinical encounter.An autonomous person is understood as one who, even with his vulnerability as a patient, makes his choices on what is good and right for him and the community of which he is a member. He is not called to surrender his autonomy when his interests may come in conflict with those of the community; rather, he is asked to exercise it wisely in order to promote his and the community's interests and good.

並列關鍵字

autonomy ； clinical encounter ； anthropology ； medicine ； philosophy ； bioethics ； medical ethics ； person