Holm Søren
Centre for Social Ethics and Policy, School of Law, University of Manchester, Manchester, M13 9PL, UK.
Center for Medical Ethics, Faculty of Medicine, HELSAM, University of Oslo, Oslo, Norway.
Monash Bioeth Rev. 2020 Dec;38(Suppl 1):32-46. doi: 10.1007/s40592-020-00104-2.
This paper develops a general approach to how society should compensate for losses that individuals incur due to public health interventions aimed at controlling the spread of infectious diseases. The paper falls in three parts. The first part provides an initial introduction to the issues and briefly outlines five different kinds of public health interventions that will be used as test cases. They are all directed at individuals and aimed at controlling the spread of infectious diseases (1) isolation, (2) quarantine, (3) recommended voluntary social distancing, (4) changes in health care provision for asymptomatic carriers of multi-resistant microorganisms, and (5) vaccination. The interventions will be briefly described including the various risks, burdens and harms individuals who are subject to these interventions may incur. The second part briefly surveys current compensation mechanisms as far as any exist and argue that even where they exist they are clearly insufficient and do not provide adequate compensation. The third part will then develop a general framework for compensation for losses incurred due to public health interventions in the infectious disease context. This is the major analytical and constructive part of the paper. It first analyses pragmatic and ethical arguments supporting the existence of an obligation on the part of the state to compensate for such losses, and then considers whether this obligation can be defeated by (1) resource considerations, or (2) issues relating to personal responsibility.
本文提出了一种关于社会应如何补偿个人因旨在控制传染病传播的公共卫生干预措施而遭受损失的总体方法。本文分为三个部分。第一部分初步介绍了这些问题，并简要概述了将用作测试案例的五种不同类型的公共卫生干预措施。它们都针对个人，旨在控制传染病的传播：（1）隔离，（2）检疫，（3）建议的自愿社交距离，（4）对多重耐药微生物无症状携带者的医疗保健提供方式的改变，以及（5）疫苗接种。将简要描述这些干预措施，包括受到这些干预措施影响的个人可能面临的各种风险、负担和伤害。第二部分简要调查了现有的补偿机制（如果存在的话），并认为即使存在这些机制，它们显然也是不够的，无法提供充分的补偿。第三部分将为传染病背景下因公共卫生干预措施而遭受的损失制定一个补偿的总体框架。这是本文主要的分析和建设性部分。它首先分析支持国家有义务补偿此类损失的务实和伦理论据，然后考虑这种义务是否会因（1）资源考虑因素，或（2）与个人责任相关的问题而被推翻。
