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題名:儒家的健康公義思想
書刊名:興大中文學報
作者:黃漢忠
作者(外文):Wong, Hon-chung
出版日期:2010
卷期:28
頁次:頁163-190
主題關鍵詞:儒家健康照護公義正常物種功能ConfucianismHealth careJusticeNormal species functioning
原始連結:連回原系統網址new window
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在當代許多討論社會資源分配公義的理論中,羅爾斯(John Rawls)的公義即公平(justice as fairness)的理論無疑是最具有代表性及影響力的公義理論。自1971年他的《公義論》(A Theory of Justice)一書誕生以後,便一直是西方學界討論公義問題的焦點,不只是許多學者對他的公義理論提出批評,亦有許多學者把他的理論應用到各個不同的領域上,其中丹尼爾斯(Norman Daniels)便把羅爾斯的公義理論延伸到健康照護的領域上。丹尼爾斯認為,健康照護的主要功能即是要盡可能維持人的正常物種功能(normal species functioning),而維持人的正常物種功能之所以重要,是由於它對於每個人所能享有的機會範圍之影響。由於羅爾斯的公平均等機會原則(principle of fair equality of opportunity)要求保障每個擁有同等才能與技能的人享有同等的機會範圍,因此透過健康照護以盡可能維持每個人的正常功能便成為了社會所應有的義務。至於影響其他決定健康的因素之社會資源分配,則丹尼爾斯認為應由羅爾斯的差異原則(difference principle)來決定。在儒家哲學中,孔子、孟子對資源分配上公義問題的明確討論並不多見。雖然「義」是孔孟所經常使用的概念,但孔孟所言之「義」大部分都是指個人行為應當與否的道德判準。然而,孔子亦曾言「不患寡而患不均」,可見孔子亦重視社會上財富不均問題,並以財富的分配應達到一定程度的平衡作為治國的重要原則。到了孟子提倡「仁政」,主張為政者應以照顧鰥、寡、孤、獨等社會上最孤苦無依的弱勢群體為施政之首要工作,並主張要「為民制產」,希望透過「井田制」的實施,讓社會上每個家庭的基本生活所需得到一定的保障,遏止豪強對土地的兼併,並使徵稅有一公平合理的標準,已隱含某種社會資源應公平分配的要求,並希望落實在具體的政策上。《禮記》中的〈禮運〉篇則除了進一步充實儒家的政治社會理論之內容外,更明確的指出儒家的政治社會理想是出於公義的要求;而〈中庸〉在言惟天下至誠者惟能盡人之性中所透顯出的「各盡其性分原則」,則更進一步要求每個人應以公平的眼光正視一切人一切物都具有天道所賦所定之性分,故一切人一切物的性分是否得到充分的實現可被視為他們是否得到公平的對待的一個關鍵指標。本文的目的,即在於根據上述所言儒家哲學中的公義思想,並以丹尼爾斯的健康公義理論作為參考架構,闡述儒家的健康公義思想。本文將首先分析丹尼爾斯的健康公義理論,然後再以此理論為對照,根據儒家的文獻,建構儒家的健康公義觀念。最後,本文將根據儒家的健康公義思想對丹尼爾斯的理論提出批評。
Among various political theories of distributive justice on social resources, John Rawls' Justice as Fairness is undoubtedly the most dominant one in contemporary western academics. One of the fruitful results in applying Rawls' theory to specific study domain derives from Norman Daniels' extension of it to the problems of health care. For Daniels, the main goal of health care is to maintain or restore human normal species functioning as possible. Since departures from normal functioning affect the normal opportunity range we may enjoy, and justice requires protecting opportunity, as suggested by Rawls' principle of fair equality of opportunity, we should owe each other in meeting our health needs, including providing health care. As to other social determinants of health, Daniels thinks that they should be governed by Rawls' difference principle.In contrast, few explicit discussions about the problems of distributive justice can be found in the philosophy of Confucius and Mencius. Though the concept of Yi was often used by them, it mostly means a criterion on the righteous of personal behavior. However, the problem of uneven distribution of wealth is still one of the main concerns in Confucian philosophy, as Confucius said that rulers should not worry about under population but about the possessions of their people have not been equally distributed to a certain extent. Moreover, Mencius thinks that taking care of the least advantaged in society, such as those widows, widowers, orphans and old without family, should be the foremost obligation of their rulers. He also thinks that the rulers should determine what means of support their people should have through the land policy he suggested, which aims at making the essentials of life available to all families in society, preventing undue possession of land by the riches and creating a just criterion for tax levying. The author of "the Operation of Rites and the Great Harmony" in the Books of Rites further developed Mencius' political thought and explicated that the political and social ideal of Confucianism is derived from its requirement of justice, and the author of "The Doctrine of Means" in the same book argued that for Confucian justice requires equality in fulfilling all kinds of beings, whether they are human or non-human, their own hsing feng, that is, requirements derived from their own essence, so that whether their hsing feng have been fully fulfilled can be served as a touchstone of whether they have been justly treated.The aim of this paper is to articulate Confucian conception of just health through its theory of justice just mentioned, with Norman Daniels' theory of just health as a framework of reference. Firstly, I offer an analysis on Daniels' theory. Secondly, I construct the Confucian conception of just health through an exegesis on its classics and contrasting it with Daniels' theory. Finally, I critically examine Daniels' theory from Confucian perspective.
期刊論文
1.Arneson, Richard J.(1989)。Equality and equal opportunity for welfare。Philosophical Studies,56(1),77-93。  new window
2.Cohen, Gerald A.(1989)。On the Currency of Egalitarian Justice。Ethics,99(4),906-944。  new window
3.Arrow, Kenneth J.(1973)。Some Ordinalist-Utilitarian Notes on Rawls's Theory of Justice。The Journal of Philosophy,70(9),245-263。  new window
4.Sen, Amartya(1979)。Equality of What?。The Tanner Lectures on Human Values,197-220。  new window
圖書
1.Engelhardt, H. Tristram Jr.(1996)。The Foundation of Bioethics。New York:Oxford University press。  new window
2.楊祖漢。中庸義理疏解。new window  延伸查詢new window
3.陳啟天(1969)。增訂韓非子校釋。臺灣商務印書館。  延伸查詢new window
4.Daniels, Norman(1985)。Just Health Care。Cambridge University Press。  new window
5.Daniels, Norman、Kennedy, Bruce、Kawachi, Ichiro(2000)。Is Inequality Bad for our Health?。Boston:Beacon Press。  new window
6.Daniels, Norman(2008)。Just Health: Meeting Health Needs Fairly。Cambridge University Press。  new window
7.Nussbaum, Martha(2000)。Women and Human Developoment。Women and Human Developoment。Cambridge。  new window
8.Buchanan, Allen、Brock, Dan W.、Daniels, Norman、Wikler, Daniel(2000)。From Chance to Choice: Genetics and Justice。From Chance to Choice: Genetics and Justice。Cambridge/New York。  new window
其他
1.(清)段玉裁(1989)。說文解字注,臺北。  延伸查詢new window
2.(唐)孔穎達(1978)。禮記正義,臺北。  延伸查詢new window
3.(宋)程顥,(宋)程頤。二程集。  延伸查詢new window
 
 
 
 
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