Resnik David B, Roman Gerard
National Institute of Environmental Health Sciences, National Institutes of Health, Box 12233, Mail Drop NH 06, Research Triangle Park, NC 27709, USA.
Bioethics. 2007 May;21(4):230-41. doi: 10.1111/j.1467-8519.2007.00547.x.
In this article, we argue that the scope of bioethical debate concerning justice in health should expand beyond the topic of access to health care and cover such issues as occupational hazards, safe housing, air pollution, water quality, food and drug safety, pest control, public health, childhood nutrition, disaster preparedness, literacy, and many other environmental factors that can cause differences in health. Since society does not have sufficient resources to address all of these environmental factors at one time, it is important to set priorities for bioethical theorizing and policy formation. Two considerations should be used to set these priorities: (1) the impact of the environmental factor on health inequality, and (2) the practicality of addressing the factor.
在本文中，我们认为，关于健康领域正义的生物伦理辩论范围应超越获得医疗保健这一话题，涵盖职业危害、安全住房、空气污染、水质、食品和药品安全、虫害控制、公共卫生、儿童营养、备灾、识字率以及许多其他可能导致健康差异的环境因素等问题。由于社会没有足够资源一次性应对所有这些环境因素，因此为生物伦理理论构建和政策制定设定优先事项很重要。应通过两个考量来设定这些优先事项：（1）环境因素对健康不平等的影响，以及（2）应对该因素的可行性。
