The Role of Moral Theory in Health Care Ethics

医疗保健、工程和媒体等领域的新技术和做法对整个社会构成了严重的道德挑战。在学术界，这些伦理挑战通常是在一门被称为应用伦理学的学科中解决的。但从事应用伦理学研究并不总是仅限于大学，在一些国家已经变得职业化：伦理学家已成为一种专家角色，尤其是在医疗保健领域，例如在临床伦理委员会。然而，这些角色需要一种专业知识，其性质仍存在争议，许多人拒绝这种专业知识的存在。尽管研究人员一直在探索如何将哲学(纯理论)伦理学科转化为更实用的背景，但他们从未以系统和协调的方式这样做过。拟议的跨学科研究网络将填补这一空白。对于道德理论在卫生保健伦理中的适当作用，普遍缺乏确定性，这体现在在大多数需要伦理专业知识的情况下，缺乏培训委员会或小组成员的核心课程。例如，临床伦理委员会的成员不一定了解不同的伦理理论，如功利主义或美德伦理学。目前也不清楚成员是否需要这些知识，因为关于医疗保健伦理的方法和道德理论的总体地位存在相关的不确定性。也有其他被广泛接受的理论，允许在不诉诸基本伦理学理论的情况下进行伦理商议。但是，如果应用伦理学不是通过简单地将道德理论应用于一个问题来完成的，那么后者的正确角色到底是什么？由于缺乏方法论上的信心，该网络最近发起了一项联合征文活动，征集领先学术期刊的《生命伦理学的方法》。为了便于管理，该网络将专注于应用伦理学中一个特别具有示范性且涉及面广泛的领域，即医疗保健伦理学。正是在这一领域，伦理专业知识的专业化最为普遍，专业和半专业伦理学家的不同角色正在被发现，例如，在国家和专业政策问题特别工作组、临床伦理委员会和一般实践中。该网络的中心重点是从不同的跨学科角度，包括理论和实践观点，批判性地评估道德理论在卫生保健伦理中的作用和意义。它将全面了解道德理论在医疗保健伦理学中的地位，并指出目前利用道德专业知识的做法的缺陷，从而使政策制定者能够重新思考如何将伦理学付诸实践。我们将邀请来自不同学术和非学术背景的伦理学家，他们在不同的背景下从事医疗伦理工作，如临床伦理委员会、研究或政治。我们将共同探索每个人是如何构思他们的专业知识的，他们遇到的理论问题的种类，以及不同背景可能需要不同层次和风格的道德理论的可能性。这些活动及其结果将吸引不同领域的广泛受众，以及有兴趣或参与提供道德专业知识的人，例如伦理委员会成员、政治家、医生、社会工作者、律师、护士、物理治疗师、辅助医务人员、医疗技术员和医学工程师。

New technologies and practices in areas like health care, engineering, and the media pose serious ethical challenges to the whole of society. In the academic world, these ethical challenges are generally tackled in a discipline known as applied ethics. But doing applied ethics is not always confined to universities and in some countries has become professionalised: Being an ethicist has become an expert role, especially in the health care context, for instance in clinical ethics committees. However, these roles require a kind of expertise the nature of which is still debated and whose existence is rejected by many. Although researchers have always explored how the discipline of philosophical (purely theoretical) ethics is translated to a more applied context, they never have done so in a systematic and concerted fashion. The proposed interdisciplinary research network will fill this gap.The widespread lack of certainty about the proper role of moral theory in health care ethics is evidenced in the lack of a core curriculum in the training of committee or panel members in most contexts where ethical expertise is called for. A member of a clinical ethics committee, for instance, does not necessarily have knowledge about different ethical theories like utilitarianism or virtue ethics. It is not clear if members would need this knowledge, either, because there is a related uncertainty regarding the methods of doing health care ethics and the status of moral theory in general. There are also other widely accepted theories that allow for ethical deliberation without recourse to fundamental theories of ethics. But if applied ethics is not done by simply applying a moral theory to a problem, then what exactly is the latter's proper role? This lack of methodological confidence has recently led to a joint call for papers about 'The Methods of Bioethics' of leading academic journals.To be manageable, the network will concentrate on one particularly exemplary and wide-ranging area of applied ethics, namely health care ethics. It is in this area that the professionalisation of ethical expertise is most widespread and in which different roles of professional and semi-professional ethicists are being found, e.g. in national and professional task forces on policy issues, clinical ethics committees, and general practice.The central focus of the network is to critically evaluate the role and significance of moral theory in health care ethics from different, interdisciplinary angles, including theoretical and practical viewpoints. It will develop a well-rounded picture of the status of moral theory in health care ethics, and it will point out shortcomings of the current practice of utilizing moral expertise, thereby enabling policy makers to think afresh about ways to put ethics into practice.The proposal emanates from the 'Wales and Southwest Applied Ethics Network'. We will invite ethicists from a variety of academic and non-academic backgrounds, who do health care ethics in different contexts, like clinical ethics committees, research or politics. We shall jointly explore how each conceives of their expertise, the kinds of theoretical questions they encounter and the possibility that different contexts may call for different levels and styles of moral theory. The events and its outcomes will be attractive to a wide audience in diverse spheres, to people who are interested or involved in providing moral expertise, e.g. ethics committee members, politicians, doctors, social workers, lawyers, nurses, physiotherapists, paramedics, medical technologists, and medical engineers.