Bognar Greg
Faculty Fellow of Bioethics, New York University, USA.
Kennedy Inst Ethics J. 2011 Mar;21(1):1-23. doi: 10.1353/ken.2011.0000.
Cost-effectiveness analysis is the standard analytical tool for evaluating the aggregate health benefits of treatments and health programs. According to a common objection, however, its use may lead to unfair discrimination against people with disabilities. Since the disability discrimination objection is seldom articulated in a precise way, I first provide a formulation that avoids some implausible implications. Then I turn to the standard defense of cost-effectiveness analysis and argue that it does not succeed. But this does not settle the question of whether the use of cost-effectiveness analysis leads to unfair discrimination. Rather, it shows that the controversy should be approached in a different way. Thus, I conclude by outlining an alternative strategy for answering the question.
成本效益分析是评估治疗方法和健康项目总体健康效益的标准分析工具。然而,根据一种常见的反对意见,使用该工具可能会导致对残疾人的不公平歧视。由于很少有人以精确的方式阐述残疾歧视反对意见,我首先给出一种避免一些不合理含义的表述。然后我转向对成本效益分析的标准辩护,并认为其并不成功。但这并没有解决使用成本效益分析是否会导致不公平歧视的问题。相反,这表明应该以不同的方式来处理这一争议。因此,我最后概述了一种回答该问题的替代策略。