Hansson Sven Ove
Camb Q Healthc Ethics. 2018 Jan;27(1):87-92. doi: 10.1017/S0963180117000421.
In their daily clinical work, healthcare professionals generally apply what seems to be a double standard for the responsibility of patients. On the one hand, patients are encouraged to take responsibility for lifestyle changes that can improve their chances of good health. On the other hand, when patients fail to follow such recommendations, they are not held responsible for the failure. This seeming inconsistency is explained in terms of the distinction between task responsibility and blame responsibility. The double standard for responsibility is shown to be epistemologically rational, ethically commendable, and therapeutically advantageous. However, this non-blaming approach to patient responsibility is threatened by proposals to assign lower priority in healthcare to patients who are themselves responsible for their disease. Such responsibility-based priority setting requires that physicians assign blame responsibility to their patients, a practice that would run into conflict with the ethical foundations of the patient-physician relationship. Therefore, such proposals should be rejected.
在日常临床工作中，医疗保健专业人员通常对患者的责任采用一种看似双重标准的做法。一方面，鼓励患者对能够改善其健康状况的生活方式改变负责。另一方面，当患者未能遵循此类建议时，他们并不为这种失败承担责任。这种看似不一致的情况可以用任务责任和责备责任之间的区别来解释。责任的双重标准在认识论上是合理的，在伦理上是值得称赞的，并且在治疗上是有利的。然而，这种不对患者责任进行责备的方法受到了一些提议的威胁，这些提议主张在医疗保健中降低对自身疾病负有责任的患者的优先级。这种基于责任的优先级设定要求医生将责备责任归咎于他们的患者，而这种做法将与医患关系的伦理基础发生冲突。因此，此类提议应被拒绝。
