适应与疾病严重程度:痛苦的意义。

IF 2.3 2区 哲学 Q1 ETHICS Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI:10.1007/s11019-023-10155-x
Borgar Jølstad
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引用次数: 0

摘要

对疾病的适应及其与卫生保健分配的相关性一直是激烈辩论的主题。在这篇论文中,我研究了这个讨论中迄今为止似乎被忽视的一个方面:有些疾病很难,甚至不可能适应。这很重要,因为适应可以减少痛苦。在一些国家,疾病严重程度是确定重点的标准。在考虑严重程度时,我们感兴趣的是疾病使一个人的病情恶化的程度。我认为,在确定一个人的健康状况恶化到何种程度时,没有一个看似合理的幸福理论可以忽视痛苦。我们应该接受,在其他条件相同的情况下,适应一种疾病可以通过减少痛苦来减轻疾病的严重程度。接受幸福的多元理论可以让我们接受我的论点,同时也为适应有时是不好的这种可能性留有余地。最后,我认为我们应该将适应性概念化为疾病的一个特征,从而在群体层面上考虑适应,以便确定优先事项。
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Adaptation and illness severity: the significance of suffering.

Adaptation to illness, and its relevance for distribution in health care, has been the subject of vigorous debate. In this paper I examine an aspect of this discussion that seems so far to have been overlooked: that some illnesses are difficult, or even impossible, to adapt to. This matters because adaptation reduces suffering. Illness severity is a priority setting criterion in several countries. When considering severity, we are interested in the extent to which an illness makes a person worse-off. I argue that no plausible theory of well-being can disregard suffering when determining to what extent someone is worse-off in terms of health. We should accept, all else equal, that adapting to an illness makes the illness less severe by reducing suffering. Accepting a pluralist theory of well-being allows us to accept my argument, while still making room for the possibility that adaptation is sometimes, all things considered, bad. Finally, I argue that we should conceptualize adaptability as a feature of illness, and thereby account for adaptation on a group level for the purposes of priority setting.

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来源期刊
CiteScore
4.30
自引率
4.80%
发文量
64
期刊介绍: Medicine, Health Care and Philosophy: A European Journal is the official journal of the European Society for Philosophy of Medicine and Health Care. It provides a forum for international exchange of research data, theories, reports and opinions in bioethics and philosophy of medicine. The journal promotes interdisciplinary studies, and stimulates philosophical analysis centered on a common object of reflection: health care, the human effort to deal with disease, illness, death as well as health, well-being and life. Particular attention is paid to developing contributions from all European countries, and to making accessible scientific work and reports on the practice of health care ethics, from all nations, cultures and language areas in Europe.
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