Abstract
It is indispensable for teachers in bioethics to be able to establish a certain framework, which gives guidance to students as to how to think about and discuss practical cases involving moral dilemma in medical / health care settings. Unfortunately, there has been no such framework in medical / health care practices, not even in theoretical methodologies ; e.g. Principlism, New Casuistry or Rawlsianism can not function as a mediator to connect medical / health care practice and philosophical thinking. This mediating requires, as its pre-condition, differentiating among practical fields or domains, and among decision-making levels. The framework in each domain should be composed of the following elements : (1) Fundamental features, values and goals, and responsibilities of all those involved in each domain. (2) Steps and well-ordered intrinsic topics which should be considered in a particular decision-making process. (3) Moral issues involved in those steps or topics which are transformed into systematic concepts or questions. Such general ideas will later be applied to a special domain of a medical / health care one in detail. In conclusion, practical or applied philosophers in bioethics should not judge or act directly by themselves. But they should establish an intrinsic framework for the medical / health care domain, consider questions or concepts from philosophical, historical and cultural viewpoints, and give basis to the discussion of moral dilemma. As a result, they will help all those involved in medical / health care practices to reflect themselves critically and make appropriate decisions.
