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从利己主义到团结互助:实现难民健康的一条途径。

From self-interest to solidarity: One path towards delivering refugee health.

作者信息

West-Oram Peter G N

出版信息

Bioethics. 2018 Jul;32(6):343-352. doi: 10.1111/bioe.12472.

Abstract

The recent and ongoing refugee crisis in Europe highlights conflicting attitudes about the rights of migrants and refugees to health care in transition and destination countries. Some European and Scandinavian states, such as Germany and Sweden, have welcomed large numbers of migrants, while others, such as the U.K., have been significantly less open. In part, this is because of reluctance by certain national governments to incur what are seen as the high costs of delivering aid and care to migrants. In response to these assumptions, some theorists have argued that the appropriate way to view the health needs of migrants is not in terms of rights, but in terms of the interests of destination and transition countries-and have argued that providing care to migrants and refugees will generate benefits for their host countries. However, self-interest alone is less effective at motivating the provision of care for health deprivations that do not pose a threat to third parties, or to migrants and refugees in poor or distant countries. In this paper, I argue that while self-interest is unlikely in itself to motivate the provision of all necessary health care to all migrants and refugees, and may risk stigmatizing already vulnerable persons, it can provide the foundation upon which such motivations can be built. My goal is therefore to show how and why a more just approach to the provision of health care to migrants can and should be derived from narrower, self-interested commitments to preserving citizen health.

摘要

欧洲近期及仍在持续的难民危机凸显了在转型国家和目的地国家中,对于移民和难民获得医疗保健权利存在相互冲突的态度。一些欧洲国家和斯堪的纳维亚国家,比如德国和瑞典,已经接纳了大量移民,而其他国家,如英国,则开放程度明显较低。部分原因在于某些国家政府不愿承担向移民提供援助和护理所被视为的高昂成本。针对这些假设,一些理论家认为,看待移民健康需求的恰当方式并非从权利角度出发,而是从目的地国家和转型国家的利益角度出发——并且认为向移民和难民提供护理将为接纳国带来益处。然而,仅出于自身利益在促使为那些对第三方不构成威胁的健康匮乏状况,或为贫困或遥远国家的移民和难民提供护理方面效果欠佳。在本文中,我认为尽管自身利益本身不太可能促使为所有移民和难民提供一切必要的医疗保健,而且可能有给已然脆弱的人群带来污名化的风险,但它可以为建立此类动机奠定基础。因此我的目标是展示如何以及为何能够且应当从维护公民健康这一较狭隘的自身利益承诺中,推导出一种对待移民医疗保健的更公正方法。

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