Baily M A
J Health Polit Policy Law. 1984 Fall;9(3):489-501. doi: 10.1215/03616878-9-3-489.
This article describes an attempt to persuade the members of a presidential commission on ethics in medicine to open a public dialogue on the rationing of medical care. The need for limits on the health care individuals receive, and the reasons why the existing delivery system fails to set such limits in an ethically acceptable manner, were outlined. It was argued that although the term "rationing" is appropriate to describe the process of setting equitable limits, the word generates so much controversy that it is avoided; this very avoidance is an obstacle to the development of sound policy. As an ethics commission, it was argued, the Commission was in a unique position to educate the public about the need for limits, and to defuse some of the controversy surrounding the word rationing. The Commissioners were not persuaded. They accepted the case for limits, in substance, but refused to use the word rationing in their report.
本文描述了一次说服一个医学伦理总统委员会成员就医疗资源分配展开公开对话的尝试。文中概述了对个人所接受医疗保健进行限制的必要性，以及现有医疗服务体系未能以符合伦理道德的可接受方式设定此类限制的原因。有人认为，尽管“资源分配”一词适用于描述设定公平限制的过程，但这个词引发了太多争议以至于人们避而不用；而这种回避本身就是健全政策发展的障碍。有人认为，作为一个伦理委员会，该委员会处于一个独特的位置，可以就限制的必要性对公众进行教育，并化解围绕“资源分配”一词的一些争议。但委员会成员并未被说服。他们在实质上接受了限制的理由，但在报告中拒绝使用“资源分配”这个词。
