自主性原则在儒家道德语境中遭遇到的困难

The Difficulties of Principle of Autonomy in the Context of Confucius Ethics

基于调研和访谈的数据,发现当前中国医疗领域中的"自主性原则"在很大程度上得到医患双方的认同和推崇,但同时这种认同和推崇却有着一定的界限。在最重要的医疗决策环节,医患双方都倾向于认为,患者主动地放弃自主权利,由医生作出决定,才是最好的方式。并且在医患双方的心目中,最理想的医患关系模式是具有明显家长制特征的"信托关系",而不是完全的患者自主。一方面,医生行善与患者自主在儒家的道德哲学中是相互矛盾的,导致行善与自主难以共存;另一方面,儒家生命伦理认为,患者自主在一定程度上构成了对医生品质的否定,因而对于自主性的推崇无法得到文化上的认同。

Based on the survey and the interview data,this paper found that the curvrent medical principle of ＂ autonomy＂ to a great extent has the agreement from doctors and patients,but at the same time the recognition and praise highly has a certain limit.In the most important link of medical decision making,both doctors are inclined to think that patients give up independent voluntarily,by the doctor to make a decision,is the best way,and both doctors in mind,the ideal model of the doctor-patient relationship is the most obvious patriarchal characteristics of trust,rather than patients with completely independent.On the one hand,the doctor do good with the patient autonomy in Confucian moral philosophy is contradictory,the lead to do good and independent coexistence.On the other hand,the Confucian ethical thought life,patient autonomy to some extent,make up the personality negation to the doctor,so for the autonomy of cultural identity cannot be obtained.