Cherry Mark J
St. Edward's University, Austin, Texas, USA.
J Med Philos. 2017 Oct 1;42(5):503-517. doi: 10.1093/jmp/jhx019.
The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: (1) What are the direct and indirect health care costs and benefits of such a voucher system in human organs? (2) Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? (3) Do vouchers contribute to the inappropriate commodification of human body parts? (4) Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges (e.g., organ exchanges, organ chains, and organ vouchers), would save more lives and further reduce human suffering.
本期《医学与哲学杂志》中的文章探讨了一项鼓励肾脏捐赠的创新代金券计划。讨论集中在一些核心的道德和政治/理论主题上:(1)这种人体器官代金券系统的直接和间接医疗成本及收益是什么?(2)代金券是否能带来更有效和高效的器官获取与分配,还是会导致移植系统中更大的不平等和低效率?(3)代金券是否会导致人体器官的不当商品化?(4)这种代金券系统与人体器官移植市场之间是否存在重大的道德差异?本文认为,虽然肾脏代金券是朝着正确方向迈出的一步,但更充分地利用基于市场的激励措施,包括但不限于易货交易(如器官交换、器官链和器官代金券),将挽救更多生命并进一步减轻人类痛苦。
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