Historical, Philosophical and Religious Studies, Umea Universitet, Umeå, Sweden
Biomedical Ethics and Law, KU Leuven, Leuven, Belgium.
J Med Ethics. 2021 Oct;47(10):684-688. doi: 10.1136/medethics-2020-106380. Epub 2021 Mar 22.
Faced with relatively old and ageing populations, a growing number of higher-income countries are struggling to provide affordable and decent care to their older citizens. This contribution proposes a new policy for dealing with this challenge. Under certain conditions, I argue that states should pay their citizens to move to foreign care homes in order to ease the pressure on domestic care institutions. This is the case if-but not necessarily only if-(1) a significant proportion of resident citizens do not currently have access to adequate aged and nursing care; (2) the care in the foreign care homes is not worse than the one that is available in domestic care homes; (3) sending states conduct regular checks to ascertain that the level of care abroad is not worse or delegate this task to reliable local monitoring bodies; (4) appropriate measures have been taken to ensure that this type of migration does not harm local residents; and (5) the public money spent on the payments is not better spent on other ways of easing the pressure on domestic care institutions. I end by defending the proposed payments against the objection that they create morally problematic inequalities by exerting greater pressure on members of lower socioeconomic classes to migrate than on their more affluent compatriots.
面对相对较老和老龄化的人口，越来越多的高收入国家正在努力为其老年公民提供负担得起的和体面的护理。本贡献提出了应对这一挑战的新政策。在某些条件下，我认为，如果（但不一定仅仅是，如果）以下情况成立，国家应该向本国公民支付费用，让他们搬到国外的养老院，以减轻国内养老院的压力：（1）相当一部分居民目前无法获得足够的老年和护理服务；（2）国外养老院的护理服务不比国内养老院的差；（3）派遣国定期进行检查，以确定国外的护理水平不低或委托可靠的当地监督机构来执行此任务；（4）已经采取了适当措施，确保这种移民不会伤害当地居民；（5）用于支付的公共资金如果不用于通过其他方式缓解国内养老院的压力，其使用效果会更好。最后，我为提议的付款进行了辩护，反对意见认为，通过对社会经济地位较低的成员施加更大的移民压力，而不是对其更富裕的同胞施加更大的压力，从而造成道德上有问题的不平等。
