外文翻译--在医疗领域的调解,是中性的干预可能吗(编辑修改稿)

外文翻译--在医疗领域的调解,是中性的干预可能吗(编辑修改稿)内容摘要：

personal qualities of the mediator. Extensive evidence from social psychology suggests that mediators are rarely immune to biases, while at the same time they routinely overestimate their ability to avoid Distinguishing personal from professional opinion about what ments to stress or avoid in mediation is much harder than Marcus suggests, even for experienced mediators. Extensive evidence from social psychology suggests that mediators are rarely immune to biases, while at the same time they routinely overestimate their ability to avoid them. Yet there is a tension here: if one side tends to dominate, for example, and if the mediator apparently works to give equal “air time” to both, then the mediator seems to be acting on behalf of one side and constraining the other. I believe this is appropriate, but in such a case, the espousal of neutrality appears misleading. If a mediator is to do anything in shaping the process, then this will inevitably involve favoring some ments, choosing which elements to draw out or suppress, and asking questions that will steer the discussion in a particular direction。 that can only be what is meant by “process management,” and inevitably it involves valueladen judgments by the So it seems the notion of neutrality is theoretically difficult and practically impossible. Mediation and Autonomy A more appropriate frame for dis cussing mediator action is as intervention that preserves or enhances participant autonomy, understood as the individual39。 s power of selfdetermination, or, as described by Dworkin, as “the capacity to reflect upon one39。 s motivational structure and to make changes in that structure.” Dworkin asserts that autonomy is central to the nature of personhood because it is the locus of choice and responsibility. It is more than decisionmaking power, since the autonomous actor also must have the means to bring those decisions about. Simply deciding to choose medicine as a career or to elect surgery instead of drug therapy is a vacuous choice without the assent and collaboration of others who have the power to help realize those decisions. Thus one part of the mediator39。 s job may be ensuring that any decision is realizable. Autonomy requires voluntary choice—that is, choice that is not dictated by others. It may be contrasted to influence, which Ruth Faden and Tom Beauchamp have suggested may be thought of in three senses: coercion, manipulation, or persuasion. Coercion, they say, occurs “if one party intentionally and successfully influences another by presenting a credible threat of unwanted and avoidable harm so severe that the person is unable to resist acting to avoid it.” Manipulation involves influence that “noncoercively alters the actual choices available to the person or… nonpersuasiv ely alter[s] the person39。 s perceptions of those choices” (p. 261). These conditions are uncontentious. However, it seems mistaken to say that persuasion necessarily detracts from autonomy. Persuasion is restricted to influence by appeal to reason, whereas manipulation involves bad reasons or poor arguments masquerading as good ones. In the words of Claudia Mills, Persuasion, understood in its ideal form, is influence that appeals only to the best reasons, broadly understood, for forming beliefs and desires, and so leading a person to a targeted conclusion. To persuade someone to do x—whether by explicitly offering arguments or even by implicitly acting in various ways—is to say (explicitly or implicitly): “There are good reasons for you to do x.” Presenting reasons does not by itself violate autonomy, since the individual is still the arbiter of choice. For example, if a woman with a heart condition wants to go bungee jumping, it would be appropriate to ensure that she is aware of the potential consequences of her decision, but it would be inappropriate to refuse her request once it had been established that she was fully aware of her actions. Similarly, someone at risk of a stroke may be counseled to give up smoking。 once educated about the likely consequences, the choice to smoke remains an individual one. However, if the mediator39。 s job is to act as an educator, this naturally begs the question of whether education can take place in a valueneutral way. Any presentation by one individual to another is likely to be tempered by a point of view. Thus even the most evenhanded exposition will probably betray the values held by the author and color the views of a receptive audience. Given these facts, it might be thought that any form of education of a client in mediation is tantamount to implicit advocacy. However, I do not think that this has to be the case: there need not be any endorsement implied in laying out facts. Surely the exposition w。