In the light of practitioners resistance, some 鉴于从业者的抵制,部分医学伦理 medical ethicists have forsaken ethical theories学家已经放弃了只有单一主导原则的 hat have a single, dominant principle in favor理论,而是选择了借用法理学做法的理 of the jurists tactic of" balancing"several I论,即“平衡”若干无优先排序的原则。 unranked principles. Decisions are to be I通过对每个案例“权衡”目前的若干权 eached by"weighing"for each case the now威原则一一即自主、行善、无伤害,以 canonical principles of autonomy, beneficence,及倘若适当的话,诚信、生命神圣和分 and non-maleficence, and, when appropr配公正一一来做出决定。 veracity. sanctity of life, and distributive Justice Critics find this procedure too dependent or 批评者认为这套程序过分依赖直 individual intuition, and have proposed various觉,并提出了几种解决方案。其中一种 remedies.On one proposal, conflicting general方案将互相矛盾的主要原则具体化,从 principles are" specified"to yield compatib而为某个具体的案例得出一套兼容的 norms for a specific case. On another;the准则。在另一种方案中,主要原则由大 general principles are supplemented or replaced量从“常识”道德引出的禁忌所补充或 by a larger number of prohibitions drawn from取代。在一种“自下而上”由中世纪的 common sense" morality.Ona" bottom up?决疑法所得到的方案中,在道德推理中 alternative drawn from Medieval casuist,itis占中心地位的不是原则而是被详细描 ichly described paradigm cases, not principles.述的范例。其他的方案则完全摈弃原 that have the central role in moral reasoning则,转而主张职业道德(正直诚实、信 Other proposals would dispense with principles托责任、同情心)、“关怀伦理学”的 altogether in favor of professional virtues关注焦点(应需、依赖和信任)和(/ ( integrity, fiduciary responsibility, compassion)或)从与病人、家属及其他相关人员的 the central concerns of" care ethics"(response I谈话中所小心构建起来的“陈述” sensitively constructed from conversations with atients. families and other attendants.In the light of practitioners' resistance, some medical ethicists have forsaken ethical theories that have a single, dominant principle in favor of the jurist’s tactic of "balancing" several unranked principles. Decisions are to be reached by "weighing" for each case the now canonical principles of autonomy, beneficence, and non-maleficence, and, when appropriate, veracity, sanctity of life, and distributive justice. 鉴于从业者的抵制，部分医学伦理 学家已经放弃了只有单一主导原则的 理论，而是选择了借用法理学做法的理 论，即“平衡”若干无优先排序的原则。 通过对每个案例“权衡”目前的若干权 威原则——即自主、行善、无伤害，以 及倘若适当的话，诚信、生命神圣和分 配公正——来做出决定。 Critics find this procedure too dependent on individual intuition, and have proposed various remedies. On one proposal, conflicting general principles are "specified" to yield compatible norms for a specific case. On another, the general principles are supplemented or replaced by a larger number of prohibitions drawn from "common sense" morality. On a "bottom up" alternative drawn from Medieval casuistry, it is richly described paradigm cases, not principles, that have the central role in moral reasoning. Other proposals would dispense with principles altogether in favor of professional virtues (integrity, fiduciary responsibility, compassion); the central concerns of "care ethics" (response to need, dependency, trust); and/or "narratives" sensitively constructed from conversations with patients, families, and other attendants. 批评者认为这套程序过分依赖直 觉，并提出了几种解决方案。其中一种 方案将互相矛盾的主要原则具体化，从 而为某个具体的案例得出一套兼容的 准则。在另一种方案中，主要原则由大 量从“常识”道德引出的禁忌所补充或 取代。在一种“自下而上”由中世纪的 决疑法所得到的方案中，在道德推理中 占中心地位的不是原则而是被详细描 述的范例。其他的方案则完全摈弃原 则，转而主张职业道德（正直诚实、信 托责任、同情心）、“关怀伦理学”的 关注焦点（应需、依赖和信任）和（/ 或）从与病人、家属及其他相关人员的 谈话中所小心构建起来的“陈述