Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping university, Linköping, Sweden.
Bioethics. 2019 Feb;33(2):261-266. doi: 10.1111/bioe.12535. Epub 2018 Nov 27.
There is a growing body of literature which suggests that decisions about healthcare priority setting should take into account the extent to which patients are worse off. However, such decisions are often based on how badly off patients are with respect to the condition targeted by the treatment whose priority is under consideration (condition-specific severity). In this paper I argue that giving priority to the worse off in terms of condition-specific severity does not reflect the morally relevant sense of being worse off. I conclude that an account of giving priority to the worse off relevant for healthcare priority setting should take into account how badly off patients are when all of their conditions are considered (holistic severity).
越来越多的文献表明，医疗保健优先事项的决策应该考虑到患者的困境程度。然而，此类决策往往基于患者在接受优先考虑的治疗所针对的疾病方面的严重程度（疾病特异性严重程度）。在本文中，我认为根据疾病特异性严重程度来优先考虑病情更严重的患者，并不能反映出在道德上更严重的困境。我的结论是，对于医疗保健优先事项设置而言，优先考虑更严重的患者的理由应该考虑到当所有病情都被考虑在内时患者的困境程度（整体严重程度）。
