Engelman Michal, Johnson Summer
Johns Hopkins Bloomberg School of Public Health, Department of Population and Family Health Sciences, Baltimore, USA.
Dev World Bioeth. 2007 Apr;7(1):8-18. doi: 10.1111/j.1471-8847.2006.00152.x.
To date, bioethics and health policy scholarship has given little consideration to questions of aging and intergenerational justice in the developing world. Demographic changes are precipitating rapid population aging in developing nations, however, and ethical issues regarding older people's claim to scarce healthcare resources must be addressed. This paper posits that the traditional arguments about generational justice and age-based rationing of healthcare resources, which were developed primarily in more industrialized nations, fail to adequately address the unique challenges facing older persons in developing nations. Existing philosophical approaches to age-based resource allocation underemphasize the importance of older persons for developing countries and fail to adequately consider the rights and interests of older persons in these settings. Ultimately, the paper concludes that the most appropriate framework for thinking about generational justice in developing nations is a rights-based approach that allows for the interests of all age groups, including the oldest, to be considered in the determination of health resource allocation.
迄今为止，生物伦理学与卫生政策领域的学术研究很少关注发展中国家的老龄化问题和代际公平问题。然而，人口结构变化正在促使发展中国家的人口迅速老龄化，因此必须解决老年人对稀缺医疗资源的索取所涉及的伦理问题。本文认为，主要在工业化程度较高的国家中形成的关于代际公平和基于年龄的医疗资源分配的传统论点，未能充分应对发展中国家老年人面临的独特挑战。现有的基于年龄的资源分配的哲学方法没有充分重视老年人对发展中国家的重要性，也没有充分考虑这些环境中老年人的权利和利益。最终，本文得出结论，思考发展中国家代际公平的最合适框架是一种基于权利的方法，这种方法在确定卫生资源分配时允许考虑所有年龄组（包括最年长者）的利益。
