履行知情同意原則在中國傳統倫理下的困境

Informed Consent and Its Current Dilemma

Abstract

LANGUAGE NOTE | Document text in Chinese; abstract also in English.

知情同意是尊重人的自主原則在診療環節的重要實踐，也是當代生命倫理學的重要組成之一，但在中國的履行卻體現出與其在西方社會建立起來的原有狀態中不同的特色。本文試圖探討形成這樣的特色與中國傳統倫理因素——例如“儒家、道家”——之間的關係，挖掘其可能的思想、制度、倫理淵源。在文章的最後，還對中國傳統倫理在當代正在發生變革的現狀及其對履行知情同意原則的積極作用進行了簡單的闡釋。

The informed consent has been practiced as a clinical and ethical principle for many years in China. With traditional emphasis on the family as a whole and a hierarchical social structure there is a strong ethic of indebtedness and obligations for one family member to others. Within this moral framework there is a special need for evoking a sense of self-restraint and communal responsibility towards the well-being of a family instead of an individual. As a result, the implementation of the informed consent in China sometimes takes a different direction. This paper intends to explore how traditional values systems, namely Confucianism, Daoism, Buddhism inf luence the way of the informed consent is interpreted and practiced. The paper has offered several specific medical cases to show the diff iculties in excising the principle of informed consent due to an absence of individual autonomy needed for a general requirement of competency and a lack of public medical information. Finally, I shall discuss the possibility of“ modernizing” traditional ethics.

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