Nunes Rui, Nunes Sofia B, Rego Guilhermina
Faculty of Medicine of the University of Porto, Estrada da Circunvalação 9925, 4250-150 Porto, EU Portugal.
Z Gesundh Wiss. 2017;25(1):1-9. doi: 10.1007/s10389-016-0762-3. Epub 2016 Aug 9.
Most developed societies recognise the existence of a basic right of access to health care of appropriate quality, considering it a positive welfare right. It can even be one of the most important achievements of pluralistic and secular societies. The main objective of this study is to suggest the foundations for a universal right to health care, meaning the right of access to health care of appropriate quality. A second objective is to propose the necessary tools so that access to health care is viable in a specific commonwealth in accordance with available resources.
To find this balance between an existing variable geometry and the actual level of resources of each specific commonwealth, the authors suggest the compatibility between Norman Daniels' "accountability for reasonableness" and the integrated view of health of the World Health Organisation through the "equal opportunity function".
The equal opportunity function appears to be an ethically acceptable solution for the existing variable geometry because it allows for different levels of provision and promotes an ethical rationing fully respecting accountability for reasonableness.
The basic right of access to health care of appropriate quality is a fundamental humanitarian principle that should be enjoyed by all citizens of all countries, and the international community should recognise the obligation to promote these ideals by any means available. Indeed, although social rights such as health care demand citizens' solidarity to be enjoyed, only with the universalisation of social rights will humanity be more equal in the future.
大多数发达社会承认存在获得适当质量医疗保健的基本权利,并将其视为一项积极的福利权利。它甚至可能是多元世俗社会最重要的成就之一。本研究的主要目的是为普遍的医疗保健权奠定基础,即获得适当质量医疗保健的权利。第二个目的是提出必要的工具,以便根据可用资源,在特定的联邦中实现医疗保健的可及性。
为了在现有的可变结构与每个特定联邦实际资源水平之间找到这种平衡,作者通过“平等机会功能”,提出诺曼·丹尼尔斯的“合理性问责制”与世界卫生组织对健康的综合观点之间的兼容性。
平等机会功能似乎是解决现有可变结构的一个符合伦理的方案,因为它允许不同的供应水平,并促进完全尊重合理性问责制的伦理配给。
获得适当质量医疗保健的基本权利是一项基本的人道主义原则,所有国家的所有公民都应享有,国际社会应认识到有义务通过一切可用手段促进这些理想。的确,尽管诸如医疗保健等社会权利需要公民团结才能享有,但只有实现社会权利的普遍化,人类未来才会更加平等。