Kluge Eike-Henner W
Department of Philosophy, University of Victoria, Victoria, British Columbia, Canada.
MedGenMed. 2007 Mar 21;9(1):57.
For decades, the problem of how to allocate healthcare resources in a just and equitable fashion has been the subject of concerted discussion and analysis, yet the issue has stubbornly resisted resolution. This article suggests that a major reason for this is that the discussion has focused exclusively on the nature and status of the material resources, and that the nature and role of the medical profession have been entirely ignored. Because physicians are gatekeepers to healthcare resources, their role in allocation is central from a process perspective. This article identifies 3 distinct interpretations of the nature of medicine, shows how each mandates a different method of allocation, and argues that unless an appropriate model of medicine is developed that acknowledges the valid points contained in each of the 3 approaches, the allocation problem will remain unsolvable.
几十年来，如何以公正、公平的方式分配医疗资源一直是人们共同讨论和分析的主题，但这个问题却一直顽固地难以解决。本文认为，造成这种情况的一个主要原因是，讨论完全集中在物质资源的性质和地位上，而医学专业的性质和作用却被完全忽视了。由于医生是医疗资源的守门人，从流程角度来看，他们在资源分配中的作用至关重要。本文确定了对医学性质的三种不同解释，展示了每种解释如何要求不同的分配方法，并认为除非建立一种适当的医学模式，承认这三种方法各自的合理之处，否则分配问题将仍然无法解决。
