Loewy E H
Department of Philosophy, University of California, Davis, USA.
Health Care Anal. 1998 Sep;6(3):185-92. doi: 10.1007/BF02678103.
An 'ideal' health care system would be unencumbered by economic considerations and provide an ample supply of well-paid health care professionals who would supply culturally appropriate optimal health care to the level desired by patients. An 'ideal' health care system presupposes an 'ideal' society in which resources for all social goods are unlimited. Changes within health care systems occur both because of changes within the system and because of changes or demands in and by the 'exterior environment'. Social systems must be in a homeostatic balance. If one component fails to accommodate itself to other forces, needs and interests within the system, the system is imperiled. It is difficult to create a just health care system in an unjust society, just as it is difficult to practise truly ethical medicine in an ethically corrupt system.
一个“理想”的医疗保健系统应不受经济因素的束缚，拥有充足的高收入医疗保健专业人员，他们能为患者提供符合其文化背景的、达到患者期望水平的最佳医疗服务。一个“理想”的医疗保健系统预设了一个“理想”的社会，即所有社会资源都是无限的。医疗保健系统内部的变化，既源于系统自身的变化，也源于“外部环境”的变化或需求。社会系统必须处于一种动态平衡状态。如果其中一个组成部分无法适应系统内的其他力量、需求和利益，那么整个系统就会受到威胁。在一个不公正的社会中难以创建一个公正的医疗保健系统，正如在一个道德败坏的体系中难以践行真正符合伦理的医学一样。
