The Applicability of Middle Level Principlism in Medical Ethical Decision Making

• Main Authors: Ping-chung Liu, 劉屏鍾
• Other Authors: Yuan-tse Lin
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/42045359420346487771

碩士 === 南華大學 === 哲學系碩士班 === 96 === 　　Medical ethics does not just deeply explore such issues as human cloning, abortion, and embryonic stem cell, but it also puts into application reasoning of ethics in medical decision making. Hence, making a medical decision using ethical principles is an ability that nursing members have to possess. Beauchamp and James F. Childress have proposed an integrated model of ethical decision making, which includes four well-known principles of medical ethics: Respect for Autonomy, Nonmaleficence, Beneficence and Justice. The main subject of this thesis is to explore the application of integrated model of ethical decision making in medical-ethic issues. 　　 　　This thesis expresses Beauchamp and Childress’ theory, including Considered Judgment, Specifying, Balance, Reflective Equilibrium, Four Principles, Common Morality Theory, Coherence Theory, and a brief introduction of Casuistry. This thesis also touches upon professional-patient relationship, the relationship between the four principles and moral character, and the criticism by other ethicists on the integrated model and the responses by Beauchamp and Childress. The integrated model of ethical decision making will then be practiced in a real medical case in order to examine whether the model can be applied in the decision making in medical cases. 　　 　　Aside from the justification and pragmatism in the process of ethical decision making, this thesis investigates the complicated relationship among principles, rules and theories. Another issue that deserves attention is the position of moral theory. 　　 　　This thesis proposes two points in the end: 1) Beauchamp and Childress’ integrated model can be applied when medical practitioners are making medical decisions; and 2) Integrated ethical decision-making model can not avoid the impact resulted in by different personal values. However, it will not affect the right or wrong of the last decision if only the decision is made after (correct) considered judgments. The conclusion is: integrated model of ethical decision making is not just a theory, but it can also be applied in the clinical practice by general medical practitioners.