Cappelen A W, Norheim O F
Division for Medical Ethics and the Philosophy of Science, Department of Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway.
J Med Ethics. 2005 Aug;31(8):476-80. doi: 10.1136/jme.2004.010421.
Lifestyle diseases constitute an increasing proportion of health problems and this trend is likely to continue. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge. Holding individuals accountable for their choices in the context of health care is, however, controversial. There are powerful arguments both for and against such policies. In this article the main arguments for and the traditional arguments against the use of individual responsibility as a criterion for the distribution of scarce health resources will be briefly outlined. It is argued that one of the most prominent contemporary normative traditions, liberal egalitarianism, presents a way of holding individuals accountable for their choices that avoids most of the problems pointed out by the critics. The aim of the article is to propose a plausible interpretation of liberal egalitarianism with respect to responsibility and health care and assess it against reasonable counter-arguments.
生活方式疾病在健康问题中所占比例日益增加，且这一趋势可能会持续下去。更好地理解责任论点对于评估旨在应对这一挑战的政策至关重要。然而，在医疗保健背景下让个人为自己的选择负责存在争议。支持和反对这类政策的理由都很充分。本文将简要概述支持将个人责任作为分配稀缺医疗资源标准的主要论据以及传统的反对论据。有人认为，当代最突出的规范传统之一，即自由平等主义，提出了一种让个人为自己的选择负责的方式，避免了批评者指出的大多数问题。本文的目的是就责任与医疗保健提出对自由平等主义的一种合理诠释，并根据合理的反驳观点对其进行评估。
