Landman W A, Henley L D
East Carolina University, Greenville, North Carolina, USA.
J Med Ethics. 1998 Aug;24(4):268-73. doi: 10.1136/jme.24.4.268.
The new South African constitution commits the government to guarantee "basic health services" for every child under 18. Primary health care for pregnant women and children under six and elements of essential primary health care have received priority. At present, there is little analysis of the moral considerations involved in making choices about more advanced or costly health care which may, arguably, also be "basic". This paper illustrates some of the tensions in setting priorities for a just macro-allocation of children's health care, given the realities of need and scarce resources, and the commitment to equality of basic opportunities.
新的南非宪法要求政府为每位18岁以下儿童保障“基本医疗服务”。孕妇和6岁以下儿童的初级医疗保健以及基本初级医疗保健的要素已得到优先考虑。目前,对于在选择可能也可被视为“基本”的更先进或成本更高的医疗保健时所涉及的道德考量,几乎没有分析。鉴于需求现实和资源稀缺,以及对基本机会平等的承诺,本文阐述了在为儿童医疗保健进行公正的宏观分配设定优先次序时存在的一些矛盾。