Utilitarianism and the pandemic
Utilitarianism and the pandemic
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DOI：
10.1111/bioe.12771
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发表时间：
2020-07-01
期刊：
影响因子：
2.2
通讯作者：
Wilkinson, Dominic
中科院分区：
文献类型：
--
作者：
Savulescu, Julian;Persson, Ingmar;Wilkinson, Dominic
大流行中没有平等主义者。卫生系统和公共政策面临的挑战之大，意味着不可避免地需要优先考虑多数人的需求。平等对待所有公民是不可能的，不仔细考虑行动的后果可能导致大量本可避免的生命损失。在大流行期间，有强烈的道德需要考虑如何总体上做得最好。功利主义是一种很有影响力的道德理论，它认为正确的行为是期望产生最大利益的行为。它提供了清晰的可操作原则。在本文中，我们总结了功利主义如何为大流行早期重要的两个具有挑战性的问题提供信息：(a)分类：如果出现供不应求的情况，哪些患者应该获得呼吸机？(b)封锁：各国应如何决定何时实施严格的社会限制，在预防COVID-19死亡与造成死亡和其他原因导致的福祉下降之间取得平衡？我们的目的不是要论证功利主义是唯一相关的伦理理论，或者支持纯粹的功利主义方法。然而，清楚地考虑哪些选择总体上最有益，将有助于社会识别和考虑其他价值的必要成本。社会可以选择接受或不接受功利主义的道路，但要清楚地了解所涉及的价值观和他们愿意付出的代价。
There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory that states that the right action is the action that is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic: (a) Triage: which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? (b) Lockdown: how should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID-19 with causing deaths and reductions in well-being from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay.