患者的自主与同一性分析

Analysis of Patient Autonomy and Individual Identity

个体同一性一直是医学伦理中的核心问题之一。深入探讨这一问题会发现对于患者自主的看法在一定程度上依赖于一个特定观点,即患者将以足够的程度保持与未来自我的心理联系。这意味着诸如信仰、欲望和价值观等心理因素会随着时间的推移而保持稳定,或者以某种方式与先前的心理因素联系在一起。意识到心理联系对于实现这一目标的重要性,并不需要在时间维度上对个体的本质做出形而上学的断言,即无需支持基于心理联系的个体同一性的形而上学理论。然而,如果假设患者在某种程度上会与未来自我保持心理上的联系,那么尊重患者自我决定的价值和道德权威才能得到理解。

Identity is a pivotal concern in the field of medical ethics.A more profound exploration of this issue reveals that perspectives on patient autonomy are,to some extent,contingent upon the assumption that patients will maintain a sufficient level of psychological continuity with their future selves.This implies that psychological elements such as beliefs,desires,and values will endure over time or be interconnected with previous psychological factors.Acknowledging the significance of psychological continuity for achieving this objective does not necessitate making metaphysical assertions about the essence of an individual over time;it does not require endorsing the metaphysical theory of individual identity based on psychological continuity.However,if we assume that patients will sustain a degree of psychological connection with their future selves,then the value and moral authority of respecting patient autonomy can be understood.