Eichelman B, Hartwig A
Department of Psychiatry, University of North Carolina, Raleigh.
Hosp Community Psychiatry. 1990 Aug;41(8):880-2. doi: 10.1176/ps.41.8.880.
Three ethical constructs of distributive justice--utilitarianism, Marxism, and the theories of John Rawls--are applied to selection of patients for treatment with clozapine. Elements of an ethical selection process include a means of monitoring the clinical effectiveness of the drug so that it is not wasted and procedures for ensuring that patients' rights to advocacy and due process are met. The authors suggest that a disproportionate number of patients with tardive dyskinesia may receive clozapine because clinicians and hospitals risk litigation if these patients continue to receive standard neuroleptics and experience worsening side effects.
分配正义的三种伦理架构——功利主义、马克思主义以及约翰·罗尔斯的理论——被应用于氯氮平治疗患者的选择中。伦理选择过程的要素包括监测药物临床疗效以避免浪费的方法，以及确保患者的辩护权和正当程序权得到满足的程序。作者指出，迟发性运动障碍患者中可能有不成比例的人数会接受氯氮平治疗，因为如果这些患者继续接受标准抗精神病药物并出现更严重的副作用，临床医生和医院会面临诉讼风险。
