效用原则在临床决策中的批判性应用

摘要

从效用原则的视角考察了临床决策的伦理基础,认为效用原则是临床决策必须认真对待的问题.随着效用论自身在发展中的不断修正,其在临床决策中的应用也在批判中逐步完善.行为效用论、规则效用论和黑尔改良的效用主义在医学实践中的应用有其自身之不足,同时临床决策中应用效用原则进行效用评价时的影响因素多且复杂,最终在实践中逐渐形成了修正效用哲学“明其道而记其功”,它的本质虽是主张功利但不完全趋利,也强调要符合道德原则,体现医学人道属性.%The essay examines the ethical basis of clinical decision-making from the perspective of the principle of utility.It regards the utilitarianism as a critical issue of clinical decision-making.With the development of utilitarianism itself,the application of utility theory in the clinical decision-making is gradually improved.It also discusses the application and insufficiency of the act-utilitarianism,the rule utilitarianism and the modified Hare's utility theory in medical practice,as well as the complexity of influencing factors on utility evaluation when making a clinical decision from the utilitarianism.Finally,it argues that the essence of modified theory on ‘obeying rules as well as counting utility'is utilitarianism,but it is incomplete utility maximum and it also stresses ethical principles of humanities.