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福禍相倚的台灣後疫情挑戰:一個比較歷史的生命倫理學視角 Mutually Embedded Fortune and Disaster in Post-Pandemic Taiwan——a comparative history approach to bioethics


作者
蔡篤堅
Author
Duu-Jian Tsai
摘要

本文以比較歷史的方法學,回顧三年來新冠流感化和感冒化並存的趨勢,透過臨床倫理決策分析,尤其是醫療契約與社會公義間在疫病控制和國際衝突的辯証關係,提出符合新時代生命倫理的倡議。比較分三個歷史時期區塊來進行。以武漢、歐美,到東南亞淪陷為第一階段。台灣失守到解封時期的國際比較為第二階段。中國疫情再起,到硬著陸式的解封,以及晚近的世界趨勢演變為第三階段。以此勾勒防疫生活日常化的道德文化和物資基礎。最後提出單純流病防疫視野的不足,尤其在全球化趨勢崩解的多元衝突年代。因此提出兼顧宏觀及微觀的道德經衍生學說,並回顧疫情演變的不同階段,倡議道法自然的三才感應,能充實當代生命倫理的思維,妥善因應生產模式轉型、開闢不同層次的和平共存新生活與世界秩序想像。

Synopsis

This paper takes a comparative historical approach inquiring into the coexist transformation toward either endemic influenza or common cold of the COVID-19 in past three years. Through clinical ethical decision analysis, especially the dialectical thinking between medical contract and social justice related to discourses on pandemic controls and international conflicts, this paper attempts to propose a bioethical perspective for a coming brand-new era. Three historical blocs have been examined.

The first time period begins with the Wuhan Outbreak and ends at the expansion of pandemic to western and southeast Asian countries. The second period is from the first local endemic outbreaks to major pandemic control policy relieve in Taiwan. The third one is roughly from the resurge outbreak in China to its sudden unblock, with an attention to most recent global trends. The moral culture and material foundation of normalization of living with pandemics will be delineated. Finally, this article reminds the insufficiency of the pure pandemic or endemic control visions, especially in an era wherein globalization has been broken down with international conflicts in various spheres. Hence, a new vison integrated both micro and macro perspectives, derived from The Book of The Way ( Tao Te Ching ), is proposed to pursuit a harmony following (individual) human being, earth and universe with a sensitivity following the nature law. In so doing, we could learn lessons from past different pandemic time periods in order to enrich the contemporary bioethics reflections. It is time for us to face appropriately the era of the mode production transformation and to create sufficient multi -layer peaceful ways for new co-existing livings as well as for new world order imaginations.