传统中国医疗伦理对当代美德医疗伦理学可作的贡献

What Can Traditional Chinese Medical Ethics Offer to Virtue Ethics of Modern Medicine

晚近20年,英语世界道德哲学的最重大发展是美德伦理学的复兴。除了新亚里士多德学派,还有休谟学派、尼采学派及基督教学派等。同样的复兴也在医疗伦理学中发生。影响世界的Beauchamp与Childress的《生命医疗伦理学原则》,也在最新版本(第6版,2009年)中不再批评美德伦理学,而且承认其优点。从此书的第三版开始分析,看书的作者如何在以后三次修订版中,修改自己对美德伦理学的立场。与现代西方不同,古代中国医疗伦理的著述,是规则导向与美德导向并重,这肯定受了儒家文化的影响。儒家伦理学一直是美德导向,今天西方美德伦理学也要向孔孟取经。礼失求诸野,今天西方的医疗伦理学都强调美德的重要性,中国的医疗伦理学难道还只停留在讨论四个道德原则的运用吗?再者,我们要提出切合这个时代需要的修养工夫,这样不单是对当代中国医疗伦理的建设,也是对世界性美德医疗伦理学的贡献。

Virtue ethics experiences a great revival in western moral philosophy in the last 20 years. In addition to an Aristotelian approach, there are also Humean, Nietzschean, and Christian approaches. The same revival can also be seen in biomedical ethics. The world famous textbook ＂ Principles of Biomedical Ethics＂ by Beauchamp and Childress is now in its 6th edition. This article analyzes the changing attitudes - from criticism to full embrace - of this book from the 3rd edition onwards. Unlike modern western medical ethics, medical ethics in traditional China is both rule - oriented and virtue - oriented as a result of the influence of Confucian ethics, which is essentially virtue ethics. In contemporary China, however, we have stressed so much the moral principles approach that we need to recover our tradition of virtue approach. In particular, we need to renew and revive the cultivation practices for nurturing our character. That will be an effort not only toward the construction of Chinese medical ethics, but also toward the revival of virtue ethics of modern medicine in the whole world.