从常识道德到专业伦理:生命伦理学理论进路的变迁

From Common Morality to Professional Ethics:the Changing of Theoretical Approach of Bioethics

生命伦理学的基础为何?这是生命伦理学家们致力于解决的元问题。比彻姆作为经典生命伦理学的代表,以常识道德作为进路,依托实证主义、规范性、概念性和方法论证明其合理性。但它遭遇了理论权威性难题、与临床实践的不相容性等质疑。罗兹主张用专业伦理取代常识道德成为生命伦理学的理论进路;比彻姆虽回应了罗兹的意见,但多以澄清问题为主,并未对专业伦理进路做出评价。常识道德沿袭了西方哲学传统的“发现确定性”的论证路径,但是它容易遗忘医学专业的社会承诺。专业伦理以“创构性”凸显其专业自治性,但实践进路也引发了理论的脆弱性问题。为此,生命伦理学需要融合两种进路:常识道德提供形式元素,专业伦理则提供质料范畴。

What is the foundation of bioethics?This is a meta issue that bioethicists are committed to answering.Tom Beauchamp,the representative of classical bioethics,takes"common morality"as their approach,and relies on"positivism,normalization,conceptualization and methodology"to prove its rationality.However,the common morality approach encounters some criticism,such as the dilemma of theoretical authority,and the incompatibility with clinical practices.Rosamond Rhodes proposes"professional ethics"to replace common morality as the moral approach of"bioethics",Although Beauchamp has responded to Rhodes′opinions,he has mostly focused on clarifying concepts rather than evaluating the professional ethics approach.Common morality follows the demonstration path of"discovering certainty"in the tradition of western philosophy,but it has the defect of neglecting the social commitment of medical profession.As a constructive model,professional ethics can highlight its professional autonomy,but its practice access has incurred the vulnerability of theory.Therefore,bioethics needs to integrate the two accesses,with common morality as the basic formal condition and professional ethics as the constructive material condition.