阿尔茨海默病患者预嘱中伦理困境的道德地位解析

Analysis on the Ethical Dilemma of Living Wills of Patients with Alzheimer's from the Perspective of Moral Status

以道德地位视角对阿尔茨海默病患者预嘱中的伦理困境进行探讨,揭示了西方强调能力与感受力的主流伦理理论缺乏对阿尔茨海默病患者保留的人类特有感受力的关照,且忽略了其外在关系特性。根据这些理论,随着阿尔茨海默病病程进展,患者将丧失(完全的)道德地位,进而相比其当前改变的意愿或利益,其在预嘱中的意愿或决定具有优先性。同时,关照人类特有内在特性与外在关系特性的双层道德地位标准为传统道德地位理论所面临的共同困境提供了新思路,按照这一标准,执行预嘱的条件是相关意愿或决定符合或不违背患者的当前权益。

This article analyzes the ethical dilemma of living wills of patients with Alzheimer's from the perspective of moral status.It reveals that western mainstream ethical theories only emphasize competency and sentience but neglect human-unique sentience properties these patients retained,and also ignore their external relationship properties.According to these theories,patients will lose their(full)moral status as the disease progresses;so their wishes or decisions in the living wills are superior to their current wishes or interests.A dual moral status standard that considers both individuals'human-unique intrinsic property and external relationship property provides a new idea for the common dilemma confronted by the traditional moral status theories.According to this standard,the execution condition of the living wills is the relevant wishes or decisions which conform to or do not violate the patients'current rights and interests.