Artificial Kidneys and the Emergence of Bioethics: The History of 'Outsiders' in the Allocation of Haemodialysis
Artificial Kidneys and the Emergence of Bioethics: The History of 'Outsiders' in the Allocation of Haemodialysis
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DOI：
10.1093/shm/hkq053
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发表时间：
2011-08-01
影响因子：
0.7
通讯作者：
Adams, David
中科院分区：
文献类型：
--
作者：
Adams, David
这篇论文对生物医学伦理学作为一个独特领域出现的公认观点提出了挑战。大卫·罗斯曼(David Rothman)和阿尔伯特·琼森(Albert Jonsen)等学者支持的这一说法说，生物伦理学始于临床医生向非专业人士寻求帮助，因为传统的医学伦理学来源没有提供指导，例如，在许多候选人中，谁应该接受稀缺的血液透析治疗。门外汉被期望提供临床医生所缺乏的道德技能。但对这一时期基本上被忽视的证据进行检查，就会发现一个不同的故事。我认为，收到的报告夸大了那些向外人敞开大门的医生希望外行人做出的贡献。这些历史材料至少在一定程度上质疑了这样一种说法，即传统的医德戒律已经不再对那些在20世纪60年代首次面对新的拯救生命的医疗技术带来的道德问题的医生的集体良知发挥作用。
This paper challenges the received view of the emergence of biomedical ethics as a distinct field. That account, championed by such scholars as David Rothman and Albert Jonsen, says that bioethics began when clinicians sought help from lay 'outsiders' because the traditional sources of medical ethics provided no guidance in deciding, for example, whom among many candidates should receive scarce haemodialysis treatments. Laypersons were expected to provide a moral skill clinicians lacked. But an examination of largely overlooked evidence from the period tells a different story. I argue that the received account overstates what those physicians who opened the doors to the outsiders expected laypersons to contribute. The historical materials at least partly contest the claim that the traditional precepts of medical ethics had ceased to operate upon the collective conscience of those physicians who in the 1960s first confronted the moral issues created by new and life-saving medical technologies.