Knight Carl, Albertsen Andreas
Bioethics. 2015 Oct;29(8):536-42. doi: 10.1111/bioe.12156. Epub 2015 Feb 17.
Palliative care serves both as an integrated part of treatment and as a last effort to care for those we cannot cure. The extent to which palliative care should be provided and our reasons for doing so have been curiously overlooked in the debate about distributive justice in health and healthcare. We argue that one prominent approach, the Rawlsian approach developed by Norman Daniels, is unable to provide such reasons and such care. This is because of a central feature in Daniels' account, namely that care should be provided to restore people's opportunities. Daniels' view is both unable to provide pain relief to those who need it as a supplement to treatment and, without justice-based reasons to provide palliative care to those whose opportunities cannot be restored. We conclude that this makes Daniels' framework much less attractive.
姑息治疗既是治疗的一个组成部分,也是照顾那些我们无法治愈的患者的最后努力。在关于健康和医疗保健分配正义的辩论中,姑息治疗应提供到何种程度以及我们这样做的原因奇怪地被忽视了。我们认为,一种突出的方法,即诺曼·丹尼尔斯提出的罗尔斯主义方法,无法提供这样的理由和这样的护理。这是因为丹尼尔斯论述中的一个核心特征,即护理应旨在恢复人们的机会。丹尼尔斯的观点既无法为那些需要缓解疼痛作为治疗补充的人提供疼痛缓解,也无法在没有基于正义的理由的情况下为那些机会无法恢复的人提供姑息治疗。我们得出结论,这使得丹尼尔斯的框架吸引力大打折扣。