McCullough L B
Center for Ethics, Medicine and Public Issues, Baylor College of Medicine, Houston, TX 77030.
J Med Philos. 1994 Oct;19(5):483-90. doi: 10.1093/jmp/19.5.483.
An orthodoxy has arisen which claims that there is a crisis in the United States health care system such that the system needs to be reformed. This essay challenges that orthodoxy by showing that we do not have a health care system in the United States. We have a non-system of health care, just as we do for virtually all basic social institutions. Challenging the current orthodoxy surfaces two ethical issues that have been ignored: creating a health care system will (a) cause resurgent paternalism and (b) pose a threat to moral pluralism.
一种正统观念已经出现，声称美国医疗保健系统存在危机，因此该系统需要改革。本文对这种正统观念提出了挑战，指出美国实际上并不存在一个医疗保健系统。我们拥有的是一个非系统的医疗保健体系，就像我们几乎所有的基本社会机构一样。对当前正统观念的挑战揭示了两个被忽视的伦理问题：建立一个医疗保健系统将（a）导致家长式作风的复苏，以及（b）对道德多元主义构成威胁。
