Lowe M, Kerridge I H, Mitchell K R
University of Newcastle, NSW, Australia.
J Med Ethics. 1995 Dec;21(6):356-60. doi: 10.1136/jme.21.6.356.
Recent literature has highlighted issues of racial discrimination in medicine. In order to explore the sometimes subtle influence of racial determinants in decisions about resource allocation, we present the case of a 53-year-old Australian Aboriginal woman with end-stage renal failure. The epidemiology of renal failure in the Australian Aboriginal population and amongst other indigenous peoples is discussed. We show that the use of utilitarian outcome criteria for resource allocation may embody subtle racial discrimination where consideration is not given to issues of justice, race, culture and gender. It is only where the processes by which resources are allocated are transparent, clearly defined and based upon consultation with individual patients that issues and justice are likely to be adequately addressed.
近期文献强调了医学领域中的种族歧视问题。为探讨种族因素在资源分配决策中有时较为微妙的影响，我们呈现了一位53岁终末期肾衰竭的澳大利亚原住民女性的病例。文中讨论了澳大利亚原住民群体及其他原住民中肾衰竭的流行病学情况。我们表明，在资源分配中使用功利主义结果标准可能体现出微妙的种族歧视，因为其中未考虑到公正、种族、文化和性别等问题。只有当资源分配过程透明、明确界定且基于与个体患者的协商时，相关问题和公正才有可能得到充分解决。
