新冠病毒疫情的倫理反思與公共衛生倫理學的建構

Ethical Reflection of Covid-19 Pandemic and Construction of Public Health Ethics

李瑞全(Shui-Chuen Lee)

新冠肺炎病毒 ； 警慎原則 ； 全球公共衛生倫理 ； 儒家 ； 個人主義 ； Covid-19 ； precautionary principle ； global public health ethics ； individualism ； Confucianism

應用倫理評論

70期（2021 / 04 / 01）

197 - 241

繁體中文

新冠肺炎病毒快速地成為全球流行疫症，使世界各國措手不及，具有最先進和完整醫療體系的美國與西歐各國都快速地淪為嚴重疫區。截至2021年二月底，全球確診人數已超過一億二千萬人，而死亡也超過二百五十萬人以上。此一疫情不但揭示出人類的醫藥體系仍然遠不能有效地回應這種全球性的疫症。它也揭露出我們不但沒有有效的跨國合作的機制，更沒有全球的公共衛生倫理共識。本文先簡要綜合到2021年2月底我們對此病毒所知的情況，作為進一步反省分析對疫情回應所應有的防疫政策和基本的倫理規範，包括超前部署，警慎原則，與各種防疫政策與行動所必須具備的條件，如必要性、有效性、最少干預、合符比例與得到公開論證等原則。本文特別申論警慎原則在公共衛生倫理中的重要性。由於全球疫症無法由個別國家獨自回應得了，我們需要一從整體人口的角度和全球性的公共衛生倫理和共識，以共同防預和消除此一疫情。本文最後鈎勒出一以全球一體的同情共感的仁心，和為己為人的互助關懷愛護的行動原則，建立共識和共同行動的公共衛生倫理學，共同渡過此一難關，以及回應未來類似的災難。

The rapid spread of Covid-19 into a pandemic saw the unpreparedness of the world for the serious attack of this virus. Even those most advanced western countries such as USA and European Union with strong and well-organized medical system quickly fell into great disaster. Up to February 2021, we have a global confirmed case more than 120 million and death over 2.5 million. This pandemic shows that our medical system is still far from capable in dealing with such pandemic, and that we do not have an effective international cooperation mechanism, not even a consensus in global public health ethics. In this paper, I shall sum up first the main features of what we learnt from the development of the pandemic covid-19 over last year as the basis for our ethical reflections and construction of our moral principles for action and policy, including how to make well-advanced readiness, the principle of precaution, and the necessary moral considerations in taking civil restriction policy and action, namely effectiveness, necessity, in proportion, least infringement and public justification. This paper elaborates how the principle of precaution plays a special role in the success for the blocking of the spread of the pandemic. As such pandemic could not be dealt successfully by individual country, we need a global consensus in public health ethics in order to fight better this kind of pandemic. Lastly, I outline how we could develop a global public health ethics with our sympathy with the sufferings of others that naturally binds us together as a whole in a moral community, and how this heart-mind of benevolence (仁,ren) with care for others that lays out the direction of our ethical construction. This global public health ethics could help us overcome this difficult time and be properly prepared for similar kinds of disasters in the future, and hopefully could help us live peacefully together.

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1. 金美華(2021)。從儒家「人文關懷」的觀點反思新冠肺炎疫情對世界的衝擊。應用倫理評論，71，161-182。
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