Allen Timothy, Selgelid Michael J
Monash Bioethics Centre, Monash University, Bldg. 11, Melbourne, VIC, 3800, Australia.
Med Health Care Philos. 2017 Dec;20(4):525-535. doi: 10.1007/s11019-017-9775-0.
The influential public health ethics framework proposed by Childress et al. includes five "justificatory conditions," two of which are "necessity" and "least infringement." While the framework points to important moral values, we argue it is redundant for it to list both necessity and least infringement because they are logically equivalent. However, it is ambiguous whether Childress et al. would endorse this view, or hold the two conditions distinct. This ambiguity has resulted in confusion in public health ethics discussions citing the Childress et al. framework, as demonstrated by debate between Resnik and Wilson and Dawson. We analyse this debate to resolve these ambiguities. Finally, we argue that the necessity/least infringement principle of the Childress et al. framework applies only in cases in which only one intervention is to be implemented to achieve one specific goal. In other cases, it is not essential to require that only the least infringing intervention be implemented.
蔡尔德雷斯等人提出的颇具影响力的公共卫生伦理框架包含五个“正当性条件”，其中两个是“必要性”和“最小侵害”。虽然该框架指出了重要的道德价值，但我们认为将必要性和最小侵害都列出来是多余的，因为它们在逻辑上是等效的。然而，蔡尔德雷斯等人是否会认同这一观点，或者认为这两个条件是不同的，并不明确。这种不明确导致在引用蔡尔德雷斯等人框架的公共卫生伦理讨论中出现了混乱，雷斯尼克与威尔逊及道森之间的争论就证明了这一点。我们分析这场争论以解决这些不明确之处。最后，我们认为蔡尔德雷斯等人框架中的必要性/最小侵害原则仅适用于为实现一个特定目标而仅实施一种干预措施的情况。在其他情况下，要求仅实施侵害最小的干预措施并非至关重要。
