Gustavsson Erik, Juth Niklas
Division of Arts and Humanities, Department of Culture and Communication, Linköping University, 581 83, Linköping, Sweden.
The National Center for Priority Setting in Health Care, Department of Medical and Health Sciences, Linköping University, 581 83, Linköping, Sweden.
Health Care Anal. 2019 Jun;27(2):77-92. doi: 10.1007/s10728-017-0346-6.
Principles of need are constantly referred to in health care priority setting. The common denominator for any principle of need is that it will ascribe some kind of special normative weight to people being worse off. However, this common ground does not answer the question how a plausible principle of need should relate to the aggregation of benefits across individuals. Principles of need are sometimes stated as being incompatible with aggregation and sometimes characterized as accepting aggregation in much the same way as utilitarians do. In this paper we argue that if one wants to take principles of need seriously both of these positions have unreasonable implications. We then characterize and defend a principle of need consisting of sufficientarian elements as well as prioritarian which avoids these unreasonable implications.
在医疗保健优先事项设定中，需求原则经常被提及。任何需求原则的共同之处在于，它会赋予处境较差的人某种特殊的规范性权重。然而，这一共识并未回答一个合理的需求原则应如何与个体间利益的汇总相关联这一问题。需求原则有时被表述为与汇总不相容，有时又被描述为在很大程度上与功利主义者一样接受汇总。在本文中，我们认为，如果有人想认真对待需求原则，那么这两种立场都有不合理的含义。然后，我们描述并捍卫一种由充足主义要素和优先主义组成的需求原则，该原则避免了这些不合理的含义。
