McKee M, Figueras J
Health Services Research Unit, London School of Hygiene and Tropical Medicine, London.
BMJ. 1996 Mar 16;312(7032):691-4. doi: 10.1136/bmj.312.7032.691.
The Swedish government recently published a report on priorities in health care. It was written by a cross party group of politicians and drew extensively on the views of the public, health professionals, experience of earlier local exercises in priority setting, and research based evidence. It laid down an ethical framework for approaching issues of health care rationing. Underpinning the framework are the principles of human dignity, need and solidarity, and cost efficiency. The Swedish approach thus contrasts with the British experience of many local initiatives but an absence of national political guidance. The absence of political consensus on many aspects of social policy in the United Kingdom is a major obstacle to developing an agreed ethical framework within which decision makers in the National Health Service can work.
瑞典政府最近发布了一份关于医疗保健优先事项的报告。该报告由一个跨党派的政治家小组撰写,广泛借鉴了公众、医疗专业人员的意见、早期地方优先事项设定活动的经验以及基于研究的证据。它为处理医疗保健资源分配问题制定了一个伦理框架。该框架的基础是人的尊严、需求与团结以及成本效益原则。因此,瑞典的做法与英国许多地方举措的情况形成对比,英国缺乏国家政治指导。在英国,社会政策的许多方面缺乏政治共识,这是在国民医疗服务体系内制定一个决策者可以遵循的商定伦理框架的主要障碍。