Schramme Thomas
School of Health Science, Centre for Philosophy, Humanities, and Law in Health Care, University of Wales Swansea, Singleton Park, Swansea, UK.
Theor Med Bioeth. 2007;28(2):121-35. doi: 10.1007/s11017-007-9031-3. Epub 2007 May 22.
In this paper, I want to scrutinise the value of utilising the concept of disease for a theory of distributive justice in health care. Although many people believe that the presence of a disease-related condition is a prerequisite of a justified claim on health care resources, the impact of the philosophical debate on the concept of disease is still relatively minor. This is surprising, because how we conceive of disease determines the amount of justified claims on health care resources. Therefore, the severity of scarcity depends on our interpretation of the concept of disease. I want to defend a specific combination of a theory of disease with a theory of distributive justice. A naturalist account of disease, together with sufficientarianism, is able to perform a gate-keeping function regarding entitlements to medical treatment. Although this combination cannot solve all problems of justice in health care, it may inform rationing decisions as well.
在本文中，我想要审视将疾病概念用于医疗保健分配正义理论的价值。尽管许多人认为，存在与疾病相关的状况是对医疗保健资源提出合理主张的先决条件，但哲学界关于疾病概念的辩论所产生的影响仍然相对较小。这令人惊讶，因为我们对疾病的构想决定了对医疗保健资源合理主张的数量。因此，资源稀缺的严重程度取决于我们对疾病概念的解释。我想要捍卫一种疾病理论与分配正义理论的特定结合。一种关于疾病的自然主义解释，再加上充足论，能够在医疗治疗权利方面发挥把关作用。尽管这种结合无法解决医疗保健领域的所有正义问题，但它也可能为配给决策提供参考。
