Ekmekci Perihan Elif, Arda Berna
Ministry of Health Turkey.
Ankara University Medical Faculty History of Medicine and Ethics, Turkey.
Acta Bioeth. 2015 Nov;21(2):227-236. doi: 10.4067/S1726-569X2015000200009.
The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice.
医学技术的巨大进步揭示了健康的社会决定因素在疾病的病因、流行率和预后方面的关键作用。这将健康权概念的内容从对医疗服务的需求,转变为对获得所有健康的社会决定因素的主张。因此,健康和健康的社会决定因素的稀缺资源的公正分配成为了伦理理论的一个问题。约翰·罗尔斯提出了一种正义理论。他的理论表明,正义原则应由处于假设初始状态的个人来决定。在初始状态下,个人就正义原则达成一致。罗尔斯提出,社会的制度应该按照这些原则来构建,以达成一个公平的社会体系。尽管罗尔斯在其理论中没有为健康权辩护,但将该理论扩展以涵盖健康权的努力迅速兴起。本文首先解释了罗尔斯理论的基本组成部分。然后介绍并在罗尔斯正义理论的论述范围内讨论了将其理论扩展以涵盖健康权的最杰出方法。