Holmes H B
Center for Genetics, Ethics and Women Amherst, Massachusetts, USA.
Health Care Anal. 2001;9(2):213-28. doi: 10.1023/A:1011338404680.
Around the world the wealthy can get their lives extended while the poor get little basic medical help. Over the same years that the field of bioethics has prospered and expanded, this disparity has increased. Reasons for the failure of bioethics to successfully address this health/wealth issue include its identification with the cognitive and social authority of medicine; its gatekeeping behavior; its funding sources; its questionable use of "principlism" and its emphasis on crises and dilemmas to the neglect of "housekeeping" issues. The work of most women in bioethics rarely addresses the health/wealth issue; if it does, their work may be ignored, as were the recommendations of Canadian feminists working under government grants. To achieve equity in health care, the structure of both medicine and bioethics needs to be changed. Yet, since bioethicists generally have accepted the status quo, this seems unlikely to happen.
在世界各地，富人能够延长寿命，而穷人却几乎得不到基本的医疗救助。在生物伦理学领域蓬勃发展、不断壮大的这些年里，这种差距一直在扩大。生物伦理学未能成功解决这一健康/财富问题的原因包括：它与医学的认知和社会权威联系在一起；它的把关行为；它的资金来源；它对“原则主义”的可疑运用；以及它对危机和困境的强调，而忽视了“日常管理”问题。大多数从事生物伦理学工作的女性很少涉及健康/财富问题；即便涉及，她们的工作也可能被忽视，就像那些在政府资助下工作的加拿大女权主义者所提出的建议一样。为了实现医疗保健的公平性，医学和生物伦理学的结构都需要改变。然而，由于生物伦理学家普遍接受了现状，这种改变似乎不太可能发生。
