Wirtz Veronika, Cribb Alan, Barber Nick
Department of Practice and Policy, School of Pharmacy, University of London, London, United Kingdom.
Health Care Anal. 2003 Dec;11(4):295-300. doi: 10.1023/B:HCAN.0000010058.58087.63.
In this paper we want to briefly illustrate the ways in which technical, ethical and political judgements of various kinds are interwoven in the processes of healthcare decision-making in the UK. Drawing upon the research for the "Choices in Health Care" project we will borrow the notion of the hidden curriculum from education to illuminate the nature of resource allocation decision processes. In particular we will indicate some of the fundamental but largely hidden political factors in play in these processes and the importance of the inchoate and implicit notion of "NHS values" in shaping UK resource allocation policies. We suggest that these more diffuse, holistic and system level value judgements are both central to understanding priority setting and at the same time difficult to reduce or abstract out into lists of single values/principles.
在本文中，我们想简要说明在英国医疗保健决策过程中，各类技术、伦理和政治判断是如何相互交织的。借鉴“医疗保健选择”项目的研究成果，我们将借用教育领域中“隐性课程”的概念，来阐明资源分配决策过程的本质。特别是，我们将指出在这些过程中发挥作用的一些基本但大多隐藏的政治因素，以及尚未成形且隐含的“国民医疗服务体系价值观”概念在塑造英国资源分配政策方面的重要性。我们认为，这些更为分散、整体且处于系统层面的价值判断，对于理解优先事项设定至关重要，同时又难以简化或提炼成单一价值观/原则列表。
