Wilmot Stephen
University of British, Columbia, 254-2175 Salal Drive, Vancouver, BC, V6K 4V2, Canada,
Med Health Care Philos. 2014 Feb;17(1):61-9. doi: 10.1007/s11019-013-9490-4.
In this paper I explore the relationship between the Canadian state and Canada's First Nations, in the context of the Canadian health care system. I argue that Canada's provision of health care to its citizens can be best understood morally in terms of a covenant, but that the covenant fails to meet the needs of indigenous peoples. I consider three ways of changing the relationship and obligations linking Canada's First Nations and the Canadian state, with regard to health care- assimilation, accommodation and separation. I argue that all of these options create problems, and at present there is a good argument for working with the status quo, accepting that First Nations are outside the covenant, and securing the state's commitment to their health care on the basis of their citizenship and the liberal principle of equal treatment of citizens by the state.
在本文中，我将在加拿大医疗保健系统的背景下探讨加拿大政府与加拿大原住民之间的关系。我认为，从道德层面来看，加拿大向其公民提供医疗保健服务最好被理解为一种契约，但该契约未能满足原住民的需求。我考虑了三种改变加拿大原住民与加拿大政府在医疗保健方面的关系和义务的方式——同化、迁就和分离。我认为所有这些选择都会带来问题，目前有充分的理由维持现状，承认原住民不在契约范围内，并基于他们的公民身份以及国家平等对待公民的自由主义原则，确保政府对他们医疗保健的承诺。
