Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden.
Department of Philosophy, Rutgers University-the State University of New Jersey, New Brunswick, New Jersey, USA.
J Med Ethics. 2017 Aug;43(8):510-514. doi: 10.1136/medethics-2016-103770. Epub 2016 Dec 16.
Recent research indicates that there is a gap in life expectancy between the rich and the poor. This raises the question: should we on egalitarian grounds use income-based equity weights when we assess benefits of alternative benevolent interventions, so that health benefits to the poor count for more? This article provides three egalitarian arguments for using income-based equity weights under certain circumstances. If income inequality correlates with inequality in health, we have reason to use income-based equity weights on the ground that health inequality is bad. If income inequality correlates with inequality in opportunity for health, we have reason to use such weights on the ground that inequality in opportunity for health is bad. If income inequality correlates with inequality in well-being, income-based equity weights should be used to mitigate inequality in well-being. Three different ways in which to construe income-based equity weights are introduced and discussed. They can be based on relative income inequality, on income rankings and on capped absolute income. The article does not defend any of these types of weighting schemes, but argues that in order to settle which of these types of weighting scheme to choose, more empirical research is needed.
最近的研究表明，富人和穷人之间的预期寿命存在差距。这就提出了一个问题：在评估替代仁慈干预措施的效益时，我们是否应该基于平等主义的理由使用基于收入的公平权重，以使穷人的健康效益得到更多的考虑？本文提供了三个在某些情况下使用基于收入的公平权重的平等主义论据。如果收入不平等与健康不平等相关，我们有理由基于健康不平等是不好的这一事实使用基于收入的公平权重。如果收入不平等与健康机会不平等相关，我们有理由基于健康机会不平等是不好的这一事实使用这种权重。如果收入不平等与幸福感不平等相关，那么应该使用基于收入的公平权重来减轻幸福感的不平等。本文介绍并讨论了三种不同的构造基于收入的公平权重的方法。它们可以基于相对收入不平等、收入排名或封顶的绝对收入。本文并没有为任何一种加权方案辩护，而是认为，为了确定选择哪种加权方案，需要进行更多的实证研究。
