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Technical expertise as an ethical form: towards an ethics of distance.

机译:技术专业知识作为一种道德形式:走向距离伦理。

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摘要

The present article proceeds from the observation that the therapeutic relationship is basically unequal. This inequality essentially concerns the respective situation of the patient and his or her doctor vis-à-vis medical knowledge. A strict professionalism guarantees that this inequality remains factual and without essential value. Yet, if both partners unreflectively allow affectivity excessively to intrude into their relationship, their behaviour may then be inspired by subconscious, rather than rational, motives. In that case, the unverifiable allegations of philanthropy or paternalism may be used to rationalise a kind of 'medical sadism' which attempts to justify the will to humiliate the patient by means of the constraints inherent in medical care. The concept of ethical form is introduced as a non-verbal criterion of ethical reliability. It is mainly a way of training the will through the application of rationally justified rules of behaviour. In this context, it is suggested that an effort to remain constantly within the limits of professionalism represents a method of training for the achievement of some degree of ethical credibility in the therapeutic relationship. In the long term, such abstinence could constitute a sort of catharsis, and thereby help to reveal the non-rational motives in medical behaviour. Contrary to the belief prevailing in modern society, the established limits of medical knowledge are not so broad. The application of these limits would probably be the best method of preventing emotions from interfering undesirably in the therapeutic relationship.
机译:本文从治疗关系基本上不平等的观察出发。这种不平等本质上涉及患者及其医生相对于医学知识的各自情况。严格的专业精神保证了这种不平等仍然是事实,没有实质性价值。但是,如果双方自愿地过分地让情感侵入他们的关系中,那么他们的行为可能会受到潜意识而非理性动机的启发。在那种情况下,无法证实的慈善或家长式指控可以用来合理化一种“医疗虐待主义”,这种“医疗虐待主义”试图通过医疗固有的约束力来证明羞辱患者的意愿。道德形式的概念是作为道德可靠性的非语言标准引入的。它主要是通过应用合理合理的行为规则来训练意志的一种方式。在这种情况下,建议始终保持在专业精神范围内的努力代表了一种在治疗关系中实现一定程度的道德信誉的培训方法。从长远来看,这种禁欲可以构成一种宣泄,从而有助于揭示医疗行为中的非理性动机。与现代社会普遍存在的信念相反,医学知识的既定限制并不那么广泛。这些限制的应用可能是防止情绪不必要地干扰治疗关系的最佳方法。

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