健康促进中的个人财务激励：它们在自主伦理中处于什么位置？
Personal financial incentives in health promotion: where do they fit in an ethic of autonomy?
机构信息
Queen Mary University of London, School of Law, London, UK.
出版信息
Health Expect. 2011 Jun;14(2):191-200. doi: 10.1111/j.1369-7625.2011.00664.x. Epub 2011 Feb 23.
AIM
This paper reviews the ethical controversy concerning the use of monetary incentives in health promotion, focussing specifically on the arguments relating to the impact on personal autonomy of such incentives.
BACKGROUND
Offering people small amounts of money in the context of health promotion and medical care has been attempted in a number of settings in recent years. This use of personal financial incentives has attracted a degree of ethical controversy. One form of criticism is that such schemes interfere with the autonomy of the patient or citizen in an illegitimate way.
METHODS
This paper presents a thematic analysis of the main arguments concerning personal autonomy and the use of monetary incentives in behaviour change.
RESULTS
The main moral objections to the uses of incentives are that they may be in general or in specific instances paternalistic, coercive, involve bribery, or undermine the agency of the person.
CONCLUSION
While incentive schemes may engage these problems on occasion, there is no good reason to think that they do so inherently and of necessity. We need better behavioural science evidence to understand how incentives work, in order to evaluate their moral effects in practice.
目的
本文回顾了在健康促进中使用金钱激励措施所引发的伦理争议，重点讨论了这些激励措施对个人自主权的影响。
背景
近年来，在健康促进和医疗保健领域，人们尝试在多种情况下向人们提供少量金钱激励。这种使用个人经济激励措施引起了一定程度的伦理争议。一种批评观点认为，此类计划以不正当的方式干扰了患者或公民的自主权。
方法
本文对涉及个人自主权和使用金钱激励措施来改变行为的主要论点进行了主题分析。
结果
反对使用激励措施的主要道德观点是，它们可能普遍或在特定情况下具有家长式作风、强制性、涉及贿赂，或破坏人的代理权。
结论
虽然激励计划有时可能会出现这些问题，但没有充分的理由认为它们必然如此。我们需要更好的行为科学证据来了解激励措施的工作原理，以便在实践中评估其道德影响。
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