Philosophy, Department for the Study of Culture, University of Southern Denmark, Odense, Denmark.
Bioethics. 2021 Mar;35(3):229-236. doi: 10.1111/bioe.12822. Epub 2020 Oct 17.
Age rationing is a central issue in the health care priority-setting literature, but it has become ever more salient in the light of the Covid-19 outbreak, where health authorities in several countries have given higher priority to younger over older patients. But how is age rationing different under outbreak circumstances than under normal circumstances, and what does this difference imply for ethical theories? This is the topic of this paper. The paper argues that outbreaks such as that of Covid-19 involve special circumstances that change how age should influence our prioritization decisions, and that while this shift in circumstances poses a problem for consequentialist views such as utilitarianism and age-weighted consequentialism, contractualism is better equipped to cope with it. The paper then offers a contractualist prudential account of age rationing under outbreak circumstances.
年龄配给是医疗保健优先排序文献中的一个核心问题，但在 COVID-19 爆发的情况下，这个问题变得更加突出，因为一些国家的卫生当局对年轻患者的优先级高于老年患者。但是，在爆发情况下的年龄配给与正常情况下有何不同，这种差异对伦理理论意味着什么？本文讨论的就是这个问题。本文认为，像 COVID-19 这样的疫情涉及特殊情况，这些情况改变了年龄应该如何影响我们的优先排序决策，虽然这种情况的转变对功利主义和年龄加权功利主义等后果主义观点构成了问题，但契约主义更有能力应对这一问题。本文随后提供了一种契约主义的审慎观点，即疫情下的年龄配给。
