预防医学的哲学与伦理基础PPT课件.ppt

预防医学的哲学与伦理基础

公共衛生與預防醫學的基本思考範疇Public:Individual:Thepublicisprimarilycomprisedoftheactionsandmotivesofdiscreteindividual.Collective:Thepublicisprimarilyconceivedaspopulationswithinsocial,economic,andpoliticalsystems.2

公共衛生與預防醫學的基本思考範疇Health:Mechanicviewthatemphasizesthetraditionalmedicaldistinctionbetweendiseaseandnon-diseaseintheindividual.Thedegreetowhichanindividualreachesanequilibriumstatewithsomatic,psychological,andsocialinfluences.3

公共衛生的決策牽涉的考量Ontology(本體論):thenatureoressenceofreality,ofbeingandexistence,thenatureofcausation.Ethics(倫理):thenatureofrightnessandthestudyofwhatactionsarerightactions.Epistemology(認識論):thestudyofhowknowledgeisgainedandthegeneralvalidityofclaimstoknowledge(howknowledgeisgainedaboutcausation).4

公共衛生倫理的定位倫理學分類基本倫理學:終極發問、道德前提、道德本質的論證應用倫理學:個人─醫學倫理屬此類社會─公共衛生與環境倫理屬此類德行倫理學:倫理教育與發展做對的決定5

醫學倫理的原則自主性(autonomy):尊重個人自決與保護喪失自主性的個人。仁愛或善意(beneficence):以個人的福祉為最優先考量與最大程度來增亦個人的健康。非惡意(non-maleficence):避免傷害個人,或至少減低傷害。公正(justice):以公平、公正態度對待每個人,儘可能公平的分配保健的福利與負擔。6

當代重要的政治哲學思想康德(Kantianism)vs.功利主義(utilitarianism)自由主義(Libertarianism)馬克斯主義(Marxism)or社會主義(socialism)自由平等主義(liberalequality)社區主義(Communitarianism)女性主義(Feminism)多文化主義(Multiculturalism)7

康德主義(Kantianism)道德責任論deontology有絕對的是非對錯不因結果而改變人本精神人是目的不是手段8

功利主義(utilitarianism)Themorallyrightactorpolicyisthatwhichproducesthegreatesthappinessforthemembersofsociety.(Bentham)遠離神權、不問道德、結果主義(consequentialism)追求效用極大化(maximizetheutility)welfarehedonism,pleasure-orientedvs.non-hedonisticmentalstateutilitykeyword:utility問題:個人效用的衝突9

自由主義(Libertarianism)自由市場經濟的擁護者,完全相信市場機能可以達成最適當的分配,又稱保守主義(conservatism)Right-wing,capitalism,pursueoverallsatisfactionMaintainmarketfreedom,limittheuseofstateforsocialpolicy“Minimalstate”:protectionagainstforce,theft,fraud,orenforcementofcontracts,…10

自由主義(Libertarianism)Nozick’sentitlementtheory:Principleoftransfer:whatever