Rivlin M M
Department of Philosophy, University of Leeds.
BMJ. 1995 May 6;310(6988):1179-82. doi: 10.1136/bmj.310.6988.1179.
Some form of rationing is necessary in medicine, and to use age as a criterion for rationing seems initially appealing. Many of the criteria currently being used for deciding the distribution of funds depend on subjective judgments. Age, however, is objective and therefore negates the need for value judgments. Justice and fairness, it is sometimes suggested, require that finite resources should be directed at young people, who have not had a chance to live their lives, rather than at elderly people, who have already lived most of theirs. The adoption of ageist policies, however, may not result in the implied savings unless care is also withdrawn. Furthermore, ageist policies, which deny elderly people treatment on the sole grounds of their age, are both unfair and discriminatory and should therefore be resisted.
在医学领域,某种形式的资源分配是必要的,而将年龄作为资源分配的标准乍一看颇具吸引力。目前用于决定资金分配的许多标准都依赖主观判断。然而,年龄是客观的,因此无需进行价值判断。有时有人认为,公正和公平要求有限的资源应投向尚未有机会充分生活的年轻人,而非已度过大部分人生的老年人。然而,除非同时减少对老年人的护理,否则采取年龄歧视性政策可能不会带来预期的节省。此外,仅以年龄为由拒绝为老年人提供治疗的年龄歧视性政策既不公平又具有歧视性,因此应予以抵制。