Naafs J
Sectie Gezondheid en Welzijn, IVA: Instituut voor sociaal-wetenschappelijk onderzoek Tilburg, Katholieke Universiteit Brabant.
Tijdschr Gerontol Geriatr. 1993 Jun;24(3):85-91.
There is a growing attention for setting limits in health care. Contemporary medical scarcity makes choices necessary, but what are the arguments? Only medical criteria for selection are accepted in the Netherlands, but that does not mean at all that age is an unimportant criterion. In this article the discussion on age as criterion for selection is reviewed. It seems that arguments are based on different basic (moral) assumptions and that age and aging can be appreciated from different points of view. There is among other things the principle of justice and the idea of a natural life-span (Daniels), the norm of a worthwhile life-time (the fair-innings argument of Harris) and the idea of old age as a period of its own (Callahan). The different starting points can lead to the same way of thinking about age as a criterion for selection. Daniels, Harris, and Callahan justify this kind of selection. The Dunning-committee however does not accept it, from the point of a fundamental equality of people, the protection of life and the principle of solidarity in our society. It seems that not only the different arguments lead towards different conclusions but also the different views on the value of old age by different groups or by society as a whole.
在医疗保健领域，设定限制正日益受到关注。当代医疗资源稀缺使得做出选择成为必要，但依据是什么呢？在荷兰，只有基于医学标准的选择才被接受，但这绝不意味着年龄不是一个重要标准。本文对将年龄作为选择标准的讨论进行了综述。似乎各种观点基于不同的基本（道德）假设，而且可以从不同角度看待年龄和衰老。其中包括正义原则和自然寿命的概念（丹尼尔斯）、有价值寿命的规范（哈里斯的公平 innings 论点）以及老年是一个独特阶段的观点（卡拉汉）。不同的出发点可能导致对将年龄作为选择标准的相同思考方式。丹尼尔斯、哈里斯和卡拉汉为这种选择提供了正当理由。然而，邓宁委员会从人的基本平等、生命保护以及我们社会的团结原则出发，并不接受这种做法。似乎不仅不同的论据会导向不同的结论，而且不同群体或整个社会对老年价值的不同看法也会如此。
