我国老人长期照护模式之伦理探析——以儒家公义理论为基础

Ethical Study on Chinese Elderly Long-term Care——Based on Theory of Confucian Justice

儒家从"不忍人之心"出发建立"各尽其性分"的公义追求,认为天地万物皆有其性分,而天地间的最大公义就是使天地万物之性分都能得以发挥。长期照护模式作为保障老人"性分"得以最大实现的机制,其自身建设须合乎公义要求,使人人都能在平等基础上得到合适的对待、每个人的自主自律权利得到尊重、弱势群体利益得到优先保障、遵循"亲亲"原则与推己及人原则等。然而我国家庭照护、社区照护、机构照护这3种照护模式在上述方面还存在诸多不足。要实现照护公义,使老人之性分得以真正实现,需强化家庭照护能力、普及社区照护与机构照护、按需分配照护模式、关注照护者与被照护者双方性分的实现、国家提供制度与资源支持等。

Confucianism constructs its just pursuit of ＂fulfilling one＇s Xingfen（individual nature） ＂ according to ＂the mind of cannot bear＂. Confucianism thinks that all things in the universe have their own Xingfen, and the greatest justice is to make all things in the universe fulfill their Xingfen as much as possible. The construction of the long-term care mode, which is a security mechanism used to maximize the realization of the Xingfen of the aged,must accord with the demand of justice. It should make everyone be appropriately treated on an equal footing, everyone＇s rights of independence and autonomy be respected, the disadvantaged groups＇ benefits be preferentially guaranteed and should follow the principles of ＂qinqin＂（giving more love to intimate people） and ＂put oneself in the place of another＂. However, the three care modes of family care, community care and institutional care are all have shortcomings in above aspects. In order to realize the caring justice and to actually realize the Xingfen of the aged, we need to strengthen the ability of family care, popularizing community care and institutional care, distributing the care modes according to one＇s needs, focusing on realizing the Xingfen of the caregivers and those being cared, providing institution and resource support and so on.