儒化中醫哲學與當代基因改造人性道德爭論

Confucianized Philosophy of Chinese Medicine and the Moral Controversy on Genetic Enhancement of Human Beings

Abstract

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

當代世界其中一個重大道德爭議是，以基因科技改造人性應否進行。一些平常學術著作不討論這類問題的西方哲學家（如Habermas, Fukuyama, Sandel）也紛紛加入討論，可見這問題的劃時代重要性。本文希望透過整理及分析傳統中國思想來看這個道德爭議。直到今天，傳統中醫並不依賴高科技。其中一個原因是《黃帝內經》中的“人與天地相應”這基本看法。然而，醫治病人始終是一個人為行動，而非天地自然所為。如何在一個強調人配合天工的思維框架中為醫者的人工行為辯護，是明清時期不少醫學哲學所討論的議題。《黃帝內經》原與《周易》及《老子》皆有相通之處，到明清時期，由於儒醫的大量出現，及朱子理學的官學地位，很多儒化（理學化）的中醫哲學便冒現。透過“人補造化”、“人補天之缺陷”、“人補天功”、“人挽回天”等新瓶，承載《中庸》的人參贊天地化育的舊酒。本文會嘗試說明這個中醫哲學的天人觀，蘊涵支持基因科技的治療用途，但不蘊涵支持基因科技的優生用途。本文的用意並非要提供一個決定性或最終的論證，終極地反駁所有贊成基因改造人性的論證。本文所起的作用，只在提供一個非西方式的思考方法，以傳統儒化中醫哲學為資源，協助人類以多元文化角度思考當代重大道德爭議。

Traditional Chinese Medicine (TCM), even in modern time, does not rely on high technology. This is partly due to TCM's worldview in which the oneness of human beings with nature is of paramount importance. But this non-reliance on high technology does not prevent TCM thinkers from recognizing that healing is still an artificial act. A philosophical justification for this artif iciality within the worldview of human-nature oneness is needed. Such philosophical justifications became more frequent in the Confucianized medicine manuals of the Ming and Qing Dynasties (1368-1644, 1644-1911 C.E.). This paper surveys and analyzes these seldom-discussed medical-philosophical writings and attempts to articulate a representative Confucian philosophical justif ication for“ human intervention into nature” in the practice of TCM. Both the necessity and the moral limits of this intervention will be noted. I shall then argue that such a worldview of“ limited human intervention into nature” is significantly different from that of the modern West since Francis Bacon, which informs some contemporary Western enthusiastic advocates of the genetic enhancement of human beings. This model will then serve illustrating an Asian way of thinking about science, technology, and values which is very different from a predominant Western paradigm.

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