Callahan D
Hastings Center, Briarcliff Manor, NY 10510.
Milbank Q. 1994;72(3):451-70.
A recent project at the Hastings Center examined the question of priority setting in the provision of mental health services. A central issue was whether those services should be prioritized independently of other health services. The answer to that question was no: they should have full parity. Even so, priority setting can be a complex venture. At the heart of any such effort will be the relationship between empirical evidence on treatment outcomes and efficacy and the political and ethical interests that legitimately bear on interpreting and using that evidence. An argument is made that a priority should be given those whose suffering and inability to function in ordinary life is most pronounced, even if the available treatment for them is comparatively less efficacious than for other conditions.
黑斯廷斯中心最近的一个项目探讨了心理健康服务提供中的优先事项设定问题。一个核心问题是,这些服务是否应独立于其他医疗服务而被列为优先事项。答案是否定的:它们应享有完全平等的地位。即便如此,设定优先事项可能是一项复杂的工作。任何此类努力的核心将是治疗结果和疗效的实证证据与合理影响对该证据的解释和使用的政治及伦理利益之间的关系。有一种观点认为,应优先考虑那些痛苦最为明显且在日常生活中功能丧失最为严重的人,即使针对他们的现有治疗相对其他病症的疗效较差。