世界是分裂的吗?——关于病人自主权、医学专业承诺和医患关系的中美比较研究

A comparative study of patient's autonomy,professional commitment and doctor-patient relationship in China and the US

中国医学伦理学者中长期以来存在着一种将美国医学伦理学视为个人主义的简单化思维趋势,并且往往以所谓"家庭主义"来界定中国医学伦理学的核心特征,这不能不说是在对两国医学伦理学的历史和现实形态上都存在着一定程度的误读和误解。通过两位中美学者的对话,对中美两国"病人自主权"的主要观念、历史发展过程和当前关注的主要问题等方面的相似与不同之处进行了比较发现,固然不同文化传统和社会历史条件会建构出不同的伦理思想和道德实践方式,但以人与真实世界的相互关系而言,中美两国的医学伦理学思考和道德实践似乎呈现出一种相似的内在发展规律,这就使人们有可能超越一种文化战争的语境而找到展开交流与合作的基础。本文呈现了这一对话的全过程,以帮助读者更准确地把握两国医学伦理学界在相关问题上的真实意见,促进该领域的跨文化比较研究,并对如何通过跨文化比较研究来促进中国医学伦理学的自我反思与理论创新进行初步探索。

There is a long-held misperception that the US medical ethics advocates individualism while the Chinese medical ethics familism. We make a comparative study on the definitions,history and major concerns about patient's autonomy between China and the US through a dialogue between two scholars from the two countries. It finds that the medical ethics and moral practices in the two countries seem to have had a similar development in terms of the relationship between human beings and the world regardless of the differences in cultural traditions and social historical conditions. We present the dialogue in this paper in the hope that it can help readers understand the real medical ethics in both countries,and promote the cross-cultural comparative research in this field. We also discuss how to promote the self-reflection and theoretical innovation in Chinese medical ethics by cross-cultural comparative studies.