卫生制度与分配正义的伦理考量

Ethical Consideration on Health System and Distributive Justice

对卫生制度的正义性问题进行伦理分析,是卫生制度改革的核心议题之一。在对当前卫生制度的公平性问题进行现实考察的基础上,认真分析卫生制度与顶层设计之间的关系,阐明卫生制度的基本价值与目标,指出卫生资源分配的四个基本层次,进而论述卫生制度的四种公平性概念。为了保证卫生制度的公平性,应该采取系统性、多元化的战略模式,才能有效地解决各种价值之间的冲突,才能构建一个在道德上得以辩护、在实践上得以实施的可行方案。

Ethical analysis of justice in health system is one of the core issues in health care reform.On the basis of a realistic investigation of the fairness of the current health care system,this paper carefully analyzes the relationship between the health care system and the top-level design,clarifies the basic values and objectives of the health care system,points out the four basic levels of health resource allocation,and then discusses the four concepts of fairness of the health care system.In order to ensure the fairness of the health care system,we should adopt a systematic and diversified strategic model in order to effectively solve the conflicts among various values and to construct a morally feasible scheme and implement it in practice.