公平与健康:罗尔斯正义原则的健康伦理意蕴

Fairness and Health: The Ethical Meaning of Health from Rawls' Principles of Justice

在罗尔斯的"原初立场"中,订约人被理想化地假定是人人健康,没有人患有疾病或会提前死亡,但是通过机会的公平平等原则,我们可以扩展罗尔斯的正义理论,使之能够解释避免健康不公平的道德重要性。同时,罗尔斯的"差异原则"又允许一定程度的不平等,因此,需要对可允许的健康不公平做出充分的解释,这样,我们就能说明罗尔斯的正义原则能够在多大程度上有助于实现健康的公平。可见,罗尔斯"作为公平的正义"理论虽然不是为健康问题而设计的,但它却为我们判断何时健康的社会决定因素的分配是正义的提供了一个较为充分的理由,它使我们能以一种更为系统的方式来思考健康伦理问题。

Contractors were ideally supposed that they were healthy and nobody would be sick and get premature death in the original position,but we can expand the theory of justice of Rawls to commentate the moral importance of avoiding health inequality through the principle of fair opportunity.The principle of difference permits inequality to some extent at the same time,therefore,we need to make full explain of health inequality to make out how can the principle of justice help realizing the equality of health.Though the theory of Rawls is not designed for health,it provides adequate reason to judge the distribution of social determinants of health and makes us thinking health ethics in a more systemic way.