知情同意 ——不同文化，不同價值

Abstract

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

當下中國的醫患關係非常緊張，看病難、看病貴似乎成了無解的難題。同時，當下中國的生命倫理原則，如“知情同意”， 幾乎都是來自西方的“舶來品”。文章指出，“講信修睦”的中國傳統文化與崇尚競爭的現代西方文化有著本質的不同，因此機械地照搬生命倫理原則，就會使這些原則成為缺乏道德正當性、邏輯合理性，以及醫療建設性的種種教條。文章旨在探討建構儒學生命倫理學的必要性和現實性。作者 認為，以中國文化建構中國生命倫理學不是一個偽命題。依靠中國生命倫理學解決當下中國的問題不僅是一項具有理論必要性和現實迫切性的歷史使命和任務，更是中國學者是否為世界文化發展做出貢獻的挑戰。

In the West, informed consent is part of the legal conditions under which people are fully informed about or can participate in their own health treatment. It emphasizes the idea that patients are autonomous and have both the legal and moral rights to control their own bodies. However, in China the original intention of this concept has been changed. The idea of protecting the patient has become a means of protecting medical professionals when they fail to fulfill their duties. A moral dilemma occurs when “foreign” ideas and principles are “imported” into China: they lack the cultural and moral foundation to be implemented effectively.

This essay provides a Confucian moral response to bioethical issues such as informed consent, pointing out their limits or even potential dangers when practiced in China. For instance, the tension implicit in informed consent has ruined the traditional model of the doctor-patient relationship that emphasizes the role of the doctor as one of caring and knowing better. As a physician, the author discusses the problems that occur in hospitals when imported ideas are deployed so dogmatically that rational principles lose their reasonableness.

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