International Journal of Chinese & Comparative Philosophy of Medicine

前言：人機關係、類器官智能、安樂死

Ellen Y. ZHANG — 2026-09-25

如何看待人機關係是當今高科技所引發的一個不可忽視的倫理問題。人際關係的核心是主體間性（intersubjectivity）與交互性（mutuality）。主體間性和交互性依賴於雙向生成內在經驗與回應，亦來源於雙向的信任與默契。然而人機關係能否等同於傳統意義上的人際關係呢？本期有三篇文章討論這個話題。 (撮要取自內文首段)

儒家倫理視域下人機如何可信？

Hua CHEN — 2026-09-25

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

人工智能深度介入社會生活，在帶來效率與便利的同時，也引發了前所未有的信任危機。這種危機不僅表現為算法黑箱導致的知情不透明，更觸及人類交往的深層結構——信任本是一種植根於主體間性的心理與德性現象，而人工智能作為非人行動者，既不具備真正的意向性，也缺乏情感與責任能力。儒家倫理以“信”為核心德目之一，將信任置於人倫秩序的存在論基礎之中。本文從儒家“信”的意涵出發，分析人工智能對人際關係信任結構的挑戰：單主體性消解了可信賴性的相互性，人機依賴侵蝕了人際心理基礎，禮的規範性難以有效調節人機互動。這些挑戰的根源在於機器缺乏主體性、心理機制與情感賦予意義的能力。儒家倫理的回應不是簡單地拒絕技術，而是在“以人為本”的價值前提下，嚴格區分人機關係與人際關係，並嘗試創構一種異於傳統人際禮儀的“人機禮儀”。這種建構的理論意義在於：從文化價值觀出發，為可信人機關係提供一種非西方中心主義的倫理方案。

The deep integration of artificial intelligence into social life, while bringing efficiency and convenience, has triggered an unprecedented crisis of trust. This crisis is not only manifested in the opacity of information associated with algorithmic black boxes; it reaches deeper into the fundamental structure of human interaction. Trust is a psychological and moral phenomenon rooted in intersubjectivity, whereas artificial intelligence, as a non-human actor, possesses neither genuine intentionality nor the capacity for emotion or responsibility. Trustworthiness (xin) is one of the core virtues of Confucianism, which situates trust within the existential foundation of the human ethical order. This paper begins with the Confucian meaning of xin and analyses the challenges that artificial intelligence poses to the trust structure of human relationships: the dissolution of dual subjectivity eliminates the mutuality of trustworthiness, human–machine dependency erodes the interpersonal psychological foundation, and the normative power of ritual (li) proves inadequate in regulating human–machine interactions. At the root of these challenges is the machine’s lack of subjectivity, of psychological mechanisms, and of the capacity to endow meaning through emotion. The Confucian ethical response is not to simply reject technology but rather, under the value premise of ‘human-centredness’, to strictly distinguish human–machine relations from human–human relations, and to attempt to construct a ‘human–machine ritual’ that differs from traditional interpersonal ritual propriety. The theoretical significance of this construction lies in offering, from the perspective of cultural values, a non-Western-centric ethical framework for trustworthy human–machine relationships.

儒家倫理視域下 iPSC 自動化系統人機關係的責任與信任建構

Yun LIU — 2026-09-25

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

高科技如誘導多能幹細胞（iPSC）的臨床轉化所依賴的自動化細胞培養、AI質控及手術輔助機器人，引發了責任歸屬模糊與信任的倫理難題，傳統以人為中心的倫理框架難以有效回應人機互動中的“黑箱决策”與責任彌散問題。本文從儒家“仁、義、禮、信”出發，提出關係性人機倫理分析框架：以“義”與“禮”明確開發者、操作者、監管者的分布式責任邊界；以“仁”與“信”論證信任不僅源於技術可靠性，更植根於人-機-機構關係中的誠意與仁心。進而提出“人技有義、人技有信”的倫理秩序，並從設計、應用、審查、監管四個層面給出實踐路徑。本文旨在為高技術醫療時代的人機關係提供植根於中華優秀傳統文化的倫理智慧，推動iPSC技術在“仁智合一”的軌道上健康發展。

The clinical application of induced pluripotent stem cells (iPSCs) increasingly depends on automated technologies, including robotic cell culture, artificial intelligence–assisted quality control, and surgical support systems. These technologies improve efficiency and precision, but they raise ethical concerns regarding the attribution of responsibility and the basis of trust in human–machine interaction. Existing human-centred ethical approaches cannot fully address black-box decision-making or the diffusion of responsibility in technologically mediated medical practice. Drawing on the Confucian concepts of ren, yi, li, and xin, this paper develops a relational framework for analysing human–machine ethics. It argues that yi and li can help define the responsibilities of developers, operators, and regulators, while ren and xin suggest that trust depends not only on technical performance but also on sincerity and benevolence in human–machine–institutional relations. On this basis, the paper proposes an ethical order of ‘human–technology with righteousness’ and ‘human–technology with trustworthiness’ and discusses practical implications for design, application, review, and regulation. The study aims to contribute a Confucian ethical perspective to the governance of advanced medical technologies and to support the responsible development of iPSC-related systems.

類器官智能的倫理邊界與儒家回應

Xiaoya HUANG — 2026-09-25

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

類器官智能作為生物技術與人工智能交叉發展的新興研究方向，兼具生物性、技術性與倫理不確定性，其發展使生命與非生命、生物智能與人工智能、人類與非人類之間的界限趨於模糊，並引發意識風險、道德地位、責任歸屬、技術濫用及公平分配等倫理問題。從儒家倫理視角看，類器官智能還觸及“仁”的推擴邊界、“禮”的規範秩序以及“萬物一體” “天人合一”的宇宙觀，極需在“義利之辨”中平衡技術創新與德性目標。為此，本文在哲學維度提出連續生命譜系模型、廣義生態智能觀及多主體協同生態哲學框架，並融合儒家“仁愛差等”、“推己及物”的思想資源，構建三級道德地位評估體系，完善多層主體協同治理模式，以確保這一前沿技術能够在儒家“生生之德”與倫理框架內負責任地發展，持續為人類社會創造福祉。

Organoid intelligence (OI), an emerging research field at the intersection of biotechnology and artificial intelligence, combines biological characteristics, technological mediation, and ethical uncertainty. Its development increasingly blurs the boundaries between life and non-life, biological intelligence and artificial intelligence, and humans and non-humans, while raising ethical issues concerning consciousness-related risks, moral status, responsibility attribution, technological misuse, and distributive justice. From the perspective of Confucian ethics, OI also raises questions about the scope of extending ren (benevolence), the normative order of li (ritual propriety), and the cosmological ideas of ‘the unity of all things’ and ‘the unity of Heaven and humanity’. In response, this article takes a philosophical perspective to propose a model of life as a continuous spectrum, a broad ecological conception of intelligence, and a multi-actor collaborative framework for ecological philosophy. Further drawing on the Confucian ideas of graded benevolence and extending moral concern from oneself to other beings, it develops a three-tier system for assessing moral status and refines a multi-level collaborative governance model. The aim is to provide an appropriate ethical framework for ensuring that this frontier technology develops responsibly within the Confucian ideal of the ‘virtue of shengsheng’ (generative vitality) while continuing to contribute to human well-being.

人與性愛機械人的親密關係無與倫比？──從中西文化的人格主義評論

Vincent C. O. CHAN — 2026-09-25

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

千百年來，人類一直嘗試在有血有肉的愛侶或配偶中尋找親密關係。豈料，人工親密、虛擬親密或數碼親密（artificial intimacy）的時代已經驟然來到，如虛擬伴侶和人類與仿生性愛機器人之間的“人機性愛”。本文將會從人格主義（personalism）的角度評價人機性愛，而主要批評的對像是大衛．列維（David Levy）──他堅信人機性愛比人類的性愛更勝一籌。本文會首先介紹布伯（Martin Buber）有關真偽“我─爾關係”的觀點，然後用來指出人機性愛的種種問題。最後我們會初步探索，究竟在中國文化傳統中有沒有類似的人格主義思想，可幫助我們分析和評價人機親密關係呢？

For millennia, human beings have sought intimacy with flesh-and-blood lovers or spouses. However, the era of artificial, virtual, and digital intimacy, as manifested in virtual companions and sexual interaction between humans and android sex robots, has arrived with remarkable speed. This paper evaluates human–robot sex from the perspective of personalism. Its primary critique targets David Levy, who firmly believes that human–robot sex is superior to human–human sex. The paper uses Martin Buber’s framework regarding authentic versus pseudo ‘I–thou’ relationships to point out the problems inherent in human–robot sex. Finally, the paper conducts a preliminary exploration of whether traditional Chinese culture contains analogous personalist thought that can contribute to the analysis and evaluation of intimate human–machine relationships.

從佛教與當代倫理學的對談看佛教對醫助自殺的回應與轉變

Chen LIANG — 2026-09-25

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

本文以釋昭慧與彼得．辛格的對話為線索，探討佛教倫理對醫助自殺與自願安樂死的回應與轉變。佛教傳統上反對主動終結生命，但在面對不可逆的病痛與個體苦難時，釋昭慧提出應以慈悲為原則，謹慎對待安樂死，並宣導安寧療護等替代方案。她強調臨終“識”的清明對來世影響深遠，且主張在極端情況下，若病人在清明狀態下自願求死，應與一般自殺區分。文章揭示佛教倫理在現代醫療背景下的調適趨勢，提供了新的思考路徑。

This paper, framed by the dialogue between Ven. Shih Chao-hwei and Peter Singer, explores the evolution of Buddhist ethics concerning physician-assisted suicide and voluntary euthanasia. While traditional Buddhism opposes the active termination of life, Ven. Shih Chao-hwei, when faced with irreversible illness and individual suffering, proposed that euthanasia should be approached cautiously, guided by the principle of compassion (karuṇā). She also advocated for alternative solutions such as hospice and palliative care. She emphasised the profound impact on others’ lives of maintaining a lucid consciousness (vijñāna) at the moment of death. In extreme circumstances, she argued, a request for death voluntarily made by a patient in a lucid state should be distinguished from ordinary suicide. This article reveals an adaptive trend in Buddhist ethics within the context of modern medicine, offering new paths for consideration.