Institute for Futures Studies, Stockholm, Sweden, Lund University, Lund, Sweden.
University of Gothenburg, Gothenburg, Sweden.
J Med Philos. 2023 Jun 20;48(4):373-383. doi: 10.1093/jmp/jhad022.
How should scarce health-related resources be allocated? This paper argues that values that apply to these decisions fail to always fully determine what we should do. Health maximization and allocation-according-to-need are suggested as two values that should be part of a general theory of how to allocate health-related resources. The "small improvement argument" is used to argue that it is implausible that one alternative is always better, worse, or equal to another alternative with respect to these values. Approaches that rely on these values are thus incomplete. To deal with this, it is suggested that we ought to use incomplete theories in a two-step process. Such a process first discards ineligible alternatives, and, second, uses reasons grounded in collective commitments to identify a unique, best alternative in the remaining set.
稀缺的卫生相关资源应该如何分配？本文认为，适用于这些决策的价值观并不能完全决定我们应该怎么做。本文提出卫生最大化和按需分配是两种应该纳入卫生相关资源分配一般理论的价值观。“小改进论证”被用来论证，在这些价值观方面，一种选择总是优于、劣于或等同于另一种选择的观点是不可信的。因此，依赖这些价值观的方法是不完整的。为了解决这个问题，本文建议我们应该在两步过程中使用不完整的理论。该过程首先摒弃不合格的选择，然后使用基于集体承诺的理由来确定剩余选择集中唯一的最佳选择。
