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Abstract 摘要

The four-principles approach to bioethics developed by Beauchamp and Childress in Principles of Biomedical Ethics is no doubt the most well known and influential example in the West of principle-based approaches to resolve ethical issues. The four principles are autonomy, non-maleficence, beneficence, and justice. This essay explores whether the four principles can be considered a universal core of morality that can be used in China to deal with current bioethical issues. It argues that although the four principles provide general guidelines, their implementation is much more complex. This essay attempts to show that Daoist thought, particularly Zhuangzi’s philosophy of life and death, conveys a certain sense of bioethics and carries profound moral implications that can overcome some of the limitations of principle-based ethics. The synthesis of the two traditions may help contemporary China to deal with various kinds of moral dilemmas. The Daoist notion of the interconnection among human beings and between human beings and nature challenges the Western idea of individualism and individual autonomy.

構建中國生命倫理學基本原則所秉持的根本方法應是整合。筆者認為,莊子的生命哲學思想與比徹姆 (Tom L. Beauchamp) 和丘卓斯(James F. Childress) 的生命倫理四原則從不同的角度,為這種整合提供了理論資源。

莊子的生命哲學內涵豐富,關注生命本身、關注生命的平等和關注生命存在的本真價值與意義;秉持生是適時,死是順應的自然主義生死觀;追求超越世俗的自由“逍遙”的生存狀態;重視“養生”、“可以盡年”,實踐無慾無為的養生觀;主張“以天地為棺槨”,反對“厚葬”的陋習等等,這些都具有積極意義。這些思想歸結起來就是要“和諧”。和諧是自然萬物的存在秩序,是人的身心健康的根本保障,也是我們在構建中國生命倫理學基本原則時所需要把握的核心價值。而比徹姆和丘卓斯的生命倫理四原則從醫療衞生事業的發展與醫療實踐的角度為我們提供了更清晰、更明確去解決生命倫理問題的原則指導。

在此基礎上構建起來的中國生命倫理學基本原則是以“和諧”為中心的體現,在多領域中的原則總體,包括人與自然領域的“和諧生態”原則、人與社會領域的“和諧社會”原則、人與自身領域的“和諧人格”原則、人與醫學領域的“和諧醫學”原則等。運用這些基本原則指導人們的現實倫理生活,規範、分析和解決人們現實生活中存在的種種生命倫理問題,推進社會文明的進步與人類自我價值的提升。

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