分配卫生资源,从统计上挽救非洲宫颈癌死亡的更多生命:我们为什么要让他们死亡?

Pub Date : 2023-11-15 DOI:10.1111/dewb.12434
Adolf Kofi Awua
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引用次数: 0

摘要

在实施公共卫生干预措施时,特别是在低收入和中等收入国家,面临着资源有限这一永无止境的挑战,以及在干预措施之间进行选择这一始终存在的挑战。虽然有必要,但在大多数此类决策中缺乏伦理分析的应用,导致较少的有利结果。在将伦理原则应用于拯救妇女免于子宫颈癌的负担时,我主张通过将资源分配中的正义原则映射到当前情况,从而在统计上挽救中低收入国家的生命(投资于预防)。在这种情况下的关键事实是,提供治疗(即挽救已确定的生命)主要涉及提供姑息治疗,这与已确定的生命在接受治疗期间或治疗后不久死亡的可能性很大有关。我关注的是国家癌症预防项目与癌症治疗设施扩张之间的两难选择。
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Ration health resources to save more statistical lives from cervical cancer death in Africa: Why are we allowing them to die?

Public health interventions, particularly in low- and middle-income countries (LMICs), are implemented with the never-ending challenge of limited resources and the ever-present challenge of choosing between interventions. While necessary, the application of ethical analysis is absent in most of such decision-making, resulting in fewer favourable consequences. In applying ethical principles to the saving of women from the burden of cervical cancer, I argue in favour of saving statistical lives (investing in prevention) in LMICs, by mapping the principles of justice in resource allocation to the prevailing circumstance. The key facts in this circumstance are that providing treatment (which is saving identified lives), involves mostly providing palliative treatment, which is associated with a high likelihood of death among the identified lives while undergoing treatment or shortly thereafter. I focus on the dilemma of having a national cancer prevention program versus the expansion of cancer treatment facilities.

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