论文部分内容阅读
人们往往认为集中化的民主规则为配给提供了比个体化的医生决定更优越的基础。本文反对这种意见，探讨了基于规则的配给的缺陷。规则太不确切，不能精确反映身体和精神损伤的种种区别，以及医学科学的复杂性，尤其考虑到不同的病人赋予医疗风险和补助的广为不同的个人价值。基于规则的配给也受到利益集团对决策过程所施压力的偏差作用，往往使医生对他们实行的配给决定不负任何道德责任。使控制费用成为医生内心考虑的一部分，是配给在社会上和专业上更可接受的一个手段，并且这无论如何是不可避免的，因为即使基于规则的配给异常优越，在实行和解释规则时会留下相当领域由医生判断来作决定。结果，尽管病床边的配给有缺陷，为了完全基于规则的制度而完全抛弃它，是不明智的。
People often think that centralized democratic rules provide rations with a superior basis for individualized doctor decisions. This article opposes this opinion and explores the defects of rule-based rations. The rules are too inaccurate to accurately reflect the various differences between physical and mental injuries, as well as the complexity of medical science, especially considering the widely varying personal values that different patients have given to medical risks and subsidies. Rule-based rations are also affected by biases exerted by interest groups on the decision-making process, often leaving the doctors with no moral responsibility for the rations they make. Making control costs part of the physician’s mind is a measure that is more socially and professionally acceptable for rations, and this is unavoidable in any case because even if rule-based rations are exceptionally superior, they will be implemented and interpreted. A considerable area is left to the doctor’s discretion. As a result, despite the flaws in bedside rationing, it is unwise to completely abandon it for a completely rule-based system.