Norheim O F
Senter for medisinsk etikk, Universitetet, Oslo.
Tidsskr Nor Laegeforen. 1992 Oct 10;112(24):3115-8.
This article raises some ethical problems concerning high-cost therapy for malignant haematological diseases. The problem of setting priorities is discussed within the framework of utilitarianism, right-based theories and the contractarian theory of John Rawls. It is argued that utilitarianism can provide precise answers, based on the principle of allocative efficiency. However, this is not the only objective of a public health care system. The right-based approach is discussed, but sufficiently precise definitions seem hard to formulate. The contractarian approach is regarded as interesting, since it tries to address the question of trade-offs between objectives of allocative efficiency and distributive fairness.
本文提出了一些关于恶性血液病高成本治疗的伦理问题。在功利主义、权利本位理论和约翰·罗尔斯的契约主义理论框架内讨论了确定优先事项的问题。有人认为，功利主义可以基于分配效率原则提供精确答案。然而，这并不是公共医疗保健系统的唯一目标。文中讨论了权利本位方法，但似乎难以制定出足够精确的定义。契约主义方法被认为很有趣，因为它试图解决分配效率目标与分配公平之间的权衡问题。
