THE NEED FOR SYSTEMATIC REVIEWS OF REASONS
THE NEED FOR SYSTEMATIC REVIEWS OF REASONS
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DOI：
10.1111/j.1467-8519.2011.01858.x
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发表时间：
2012-07-01
期刊：
影响因子：
2.2
通讯作者：
Strech, Daniel
中科院分区：
文献类型：
--
作者：
Sofaer, Neema;Strech, Daniel
在卫生研究和保健的实践中，以及在政策和指导方针的制定中，有许多道德决定。我们认为，那些负责作出这种决定的人需要一种新的审查类型。这种新的类型是系统性综述的应用，系统性综述是几十年来发展起来的，目的是让医学决策者了解研究吸烟与癌症之间联系的全部研究，例如，吸烟是否会导致癌症。我们认为，有必要对基于理性的生物伦理学进行类似的包容性和严格的审查，这种伦理学使用推理来解决伦理问题。在简要介绍了系统评价的历史之后，我们拒绝了基于理性的生物伦理学系统评价的唯一现有模式，该模式认为这样的评价应该解决伦理问题。我们认为，这样一个系统的审查可能会误导决策者时，文献是不完整的，或者当有相互不相容的，但个别合理的答案的伦理问题。此外，这样的审查可以不确定讨论伦理问题时给出的所有理由，它们对伦理问题的所谓影响，以及对理由采取的态度。我们提出的评论，而不是解决的经验问题，其中的原因已经在解决一个特定的伦理问题，并提出这样的详细信息的原因。我们认为，这些信息可能会改善决策，直接和间接，也是学术文献。我们解释了我们的系统评价替代模型的局限性。
There are many ethical decisions in the practice of health research and care, and in the creation of policy and guidelines. We argue that those charged with making such decisions need a new genre of review. The new genre is an application of the systematic review, which was developed over decades to inform medical decision-makers about what the totality of studies that investigate links between smoking and cancer, for example, implies about whether smoking causes cancer. We argue that there is a need for similarly inclusive and rigorous reviews of reason-based bioethics, which uses reasoning to address ethical questions. After presenting a brief history of the systematic review, we reject the only existing model for writing a systematic review of reason-based bioethics, which holds that such a review should address an ethical question. We argue that such a systematic review may mislead decision-makers when a literature is incomplete, or when there are mutually incompatible but individually reasonable answers to the ethical question. Furthermore, such a review can be written without identifying all the reasons given when the ethical questions are discussed, their alleged implications for the ethical question, and the attitudes taken to the reasons. The reviews we propose address instead the empirical question of which reasons have been given when addressing a specified ethical question, and present such detailed information on the reasons. We argue that this information is likely to improve decision-making, both directly and indirectly, and also the academic literature. We explain the limitations of our alternative model for systematic reviews.