Hastings Cent Rep. 2016 Nov;46(6):36-42. doi: 10.1002/hast.645.
Crowdfunding websites allow users to post a public appeal for funding for a range of activities, including adoption, travel, research, participation in sports, and many others. One common form of crowdfunding is for expenses related to medical care. Medical crowdfunding appeals serve as a means of addressing gaps in medical and employment insurance, both in countries without universal health insurance, like the United States, and countries with universal coverage limited to essential medical needs, like Canada. For example, as of 2012, the website Gofundme had been used to raise a total of 8.8 million dollars (U.S.) for seventy-six hundred campaigns, the majority of which were health related. This money can make an important difference in the lives of crowdfunding users, as the costs of unexpected or uninsured medical needs can be staggering. In this article, I offer an overview of the benefits of medical crowdfunding websites and the ethical concerns they raise. I argue that medical crowdfunding is a symptom and cause of, rather than a solution to, health system injustices and that policy-makers should work to address the injustices motivating the use of crowdfunding sites for essential medical services. Despite the sites' ethical problems, individual users and donors need not refrain from using them, but they bear a political responsibility to address the inequities encouraged by these sites. I conclude by suggesting some responses to these concerns and future directions for research.
众筹网站允许用户发布公共资金申请，用于各种活动，包括收养、旅行、研究、参与体育等。众筹的一种常见形式是用于医疗费用。医疗众筹呼吁是解决医疗保险和就业保险缺口的一种手段，无论是在没有全民医疗保险的国家，如美国，还是在全民医疗保险只限于基本医疗需求的国家，如加拿大。例如，截至 2012 年，Gofundme 网站已为 7600 个活动筹集了总计 880 万美元（美国），其中大部分与健康有关。这笔钱可以给众筹用户的生活带来重要的改变，因为意外或没有保险的医疗需求的费用可能是惊人的。在本文中，我概述了医疗众筹网站的好处和它们引发的伦理问题。我认为，医疗众筹是医疗体系不公正的一个症状和原因，而不是解决办法，政策制定者应该努力解决促使人们使用众筹网站获取基本医疗服务的不公正现象。尽管这些网站存在伦理问题，但个人用户和捐赠者不必回避使用它们，但他们有政治责任来解决这些网站所鼓励的不平等现象。最后，我提出了一些对这些问题的回应和未来的研究方向。
