Afroogh S, Kazemi A, Seyedkazemi A
The State University of New York at Albany, Albany, NY, United States.
Independent Researcher in Philosophy.
Ethics Med Public Health. 2021 Sep;18:100698. doi: 10.1016/j.jemep.2021.100698. Epub 2021 Jun 18.
The principle of maximization, which roughly means that we should save more lives and more years of life, is usually taken for granted by the health community. This principle is even more forceful in crises like the COVID-19 pandemic, where we have scarce resources which can be allocated only to some patients. However, the standard consequentialist version of this principle can be challenging particularly when we have to reallocate a resource that has already been given to a patient.
Engaging in thought experiments, conceptual analysis, providing counterexamples, and appealing to moral intuitions, we challenge the standard consequentialist version of the maximization principle and make a case for adopting an alternative deontological version.
In certain cases, the standard consequentialist version of the maximization principle is shown to yield intuitively immoral results. The deontological version of this principle is preferable because it can retain the merits of the standard consequentialist version without falling prey to its problems.
Compared to the standard consequentialist version, the deontological version of the maximization principle can better guide the ethical decisions of the health community, even in cases where we face a scarcity of resources.
最大化原则大致意味着我们应该挽救更多生命和更多生命年数，通常被卫生界视为理所当然。在像新冠疫情这样的危机中，这一原则更为有力，因为我们的资源稀缺，只能分配给部分患者。然而，这一原则的标准后果主义版本可能具有挑战性，尤其是当我们必须重新分配已经给予一名患者的资源时。
通过进行思想实验、概念分析、提供反例以及诉诸道德直觉，我们对最大化原则的标准后果主义版本提出质疑，并为采用替代性的道义论版本进行论证。
在某些情况下，最大化原则的标准后果主义版本被证明会产生直观上不道德的结果。该原则的道义论版本更可取，因为它可以保留标准后果主义版本的优点，而不会陷入其问题之中。
与标准后果主义版本相比，最大化原则的道义论版本能够更好地指导卫生界的伦理决策，即使在我们面临资源稀缺的情况下也是如此。
