Edgar A
University of Wales Cardiff, School of English, Communication and Philosophy, Cardiff, UK.
Health Care Anal. 1998 Sep;6(3):193-8. doi: 10.1007/BF02678104.
By comparing models of market-based allocation with state-controlled national health care systems, it will be suggested that the way in which different communities deal with the allocation of health care is central to their expression of what might be called a moral self-understanding. That is to say that the provision of health care may be expected to be a focus of communal debate, not simply about morally acceptable and unacceptable actions, but also about the community's understanding of what it is that makes for a worthwhile and morally defensible human life. This moral self-understanding is seen to be entwined with the different concepts of 'health' that are implicit in different systems of allocation. In conclusion, it will be suggested that decisions concerning health care allocation must be made in response to a continuing, public and open debate about what health and health care mean to a particular community.
通过将基于市场的分配模式与国家控制的医疗保健系统进行比较，可以看出不同社区处理医疗保健分配的方式对于它们所表达的所谓道德自我理解至关重要。也就是说，医疗保健的提供有望成为社区辩论的焦点，这不仅涉及道德上可接受和不可接受的行为，还涉及社区对构成有价值且在道德上站得住脚的人类生活的理解。这种道德自我理解被视为与不同分配系统中隐含的不同“健康”概念交织在一起。总之，有人认为，有关医疗保健分配的决策必须回应关于健康和医疗保健对特定社区意味着什么的持续、公开且开放的辩论。
