Personal responsibility for health as a rationing criterion: why we don't like it and why maybe we should
Personal responsibility for health as a rationing criterion: why we don't like it and why maybe we should
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DOI：
10.1136/jme.2007.024059
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发表时间：
2008-12-01
影响因子：
4.1
通讯作者：
Buyx, A. M.
中科院分区：
文献类型：
--
作者：
Buyx, A. M.
将病人对自己健康的个人责任作为医疗保健的配给标准是否公平是一个有争议的问题。在医学领域，个人责任的概念存在着许多困难。其中特别包括对正义的理论考虑以及诸如医学中的多重因果因素和健康行为自由等实际问题。本文从几种正义理论的视角对个人责任进行了评价。有人认为，在一个基于机会平等和团结的医疗体系中，负责任的健康行为原则上是可以预期的。虽然与个人责任相关的实际问题很重要，但它们并不保证人们下意识地拒绝更深入地思考健康责任作为分配医疗资源的一种手段。最后，简要概述了引入个人责任作为公平配给标准的可能性。
Whether it is fair to use personal responsibility of patients for their own health as a rationing criterion in healthcare is a controversial matter. A host of difficulties are associated with the concept of personal responsibility in the field of medicine. These include, in particular, theoretical considerations of justice and such practical issues as multiple causal factors in medicine and freedom of health behaviour. In the article, personal responsibility is evaluated from the perspective of several theories of justice. It is argued that in a healthcare system based on both equality of opportunity and solidarity, responsible health behaviour can-in principle-be justifiably expected. While the practical problems associated with personal responsibility are important, they do not warrant the common knee-jerk refusal to think more deeply about responsibility for health as a means of allocating healthcare resources. In conclusion, the possibility of introducing personal responsibility as a fair rationing criterion is briefly sketched.