Abstract

Secular clinical ethics has responded to the problem of moral pluralism with a procedural approach. However, defining this term stirs debate: H. Tristram Engelhardt Jr. has championed a contentless proceduralism (P1), while others, conversely, argue for a proceduralism that permits some content in the form of moral claims (P2). This paper argues that the content P2 permits ought to be expanded to include some metaphysical commitments, in an approach referred to as P2+. The need for P2+ is demonstrated by analyzing and rejecting three standards (the best interest or harm principle, internal reasonability, and the child’s right to an open future) used by P2 to justify overriding religiously motivated refusals of treatment for children. These approaches fail because each maintains a neutral stance regarding the truth of religious belief. This paper drives at the broader thesis that the proceduralism of secular clinical ethics requires some moral and metaphysical commitments.

摘要

世俗的临床伦理学已经以一种程序化的方式回应了道德多元性的问题。但是，定义这个术语引起了争论：H. Tristram Engelhardt Jr.提倡无内容的程序主义（P1），而其他人则主张允许以道德主张的形式提供某些内容的程序主义（P2）。本文认为，应将P2许可的内容扩展为包括一些形而上的承诺，以一种称为P2 +的方式进行。通过分析和拒绝P2使用的三个标准（最高利益或伤害原则，内部合理性以及儿童享有开放未来的权利）来证明P2 +的必要性，以证明压倒一切出于宗教动机而拒绝儿童的待遇是合理的。这些方法之所以失败，是因为每种方法都对宗教信仰的真相持中立立场。