全面封锁与公平对待患者:对萨武列斯库和卡梅伦的平等主义回应。

IF 3.3 2区 哲学 Q1 ETHICS Journal of Medical Ethics Pub Date : 2024-10-22 DOI:10.1136/jme-2024-109886
Jesús Mora
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引用次数: 0

摘要

萨武列斯库和卡梅伦支持在 COVID-19 大流行期间有选择性地封锁老年人,理由有二:第一,保持全面封锁会导致夷平;第二,夷平是错误的。我们已经对他们的第一个假设进行了深入探讨,但对于他们提出的更广泛的反平均主义观点,即 "削平 "根本就是错误的,我们还可以说得更多一些。平等主义者并非无法抵御 "削平 "的反对意见。尽管有些人认为这是平等支持者面临的最严峻的挑战,但平等主义有充分的理由断言,当我们降低等级时,一些有价值的东西会被保留下来,而且在某些情况下,保留这些有价值的东西可能比追求其他基本道德目标更可取。尽管从福祉最大化的角度来看,降低等级会带来一些麻烦,但它能确保医疗保健政策反映出对人们在道德价值上是平等的这一理念的承诺。这一承诺的重要性足以压倒个人福祉的某些改善。在大流行病封锁的情况下,并非所有受自由流动保护的利益都是以平等为代价来追求的根本利益。萨武列斯库和卡梅伦的框架是如此依赖于这样一种观点,即向下拉平是错误的,以至于没有考虑到让老人独自承受痛苦所代表的宝贵损失。
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Total lockdown and fairness towards the sufferer: an egalitarian response to Savulescu and Cameron.

Savulescu and Cameron supported selectively locking down the elderly during the COVID-19 pandemic on two grounds: first, that preserving total lockdown would entail levelling down and, second, that levelling down is wrong. Their first assumption has been thoroughly addressed, but more can be said about their wider antiegalitarian point that levelling down is simply wrong. Egalitarians are not defenceless against the levelling-down objection. Even though some consider it the most serious challenge to supporters of equality, egalitarianism possesses sound reasons to assert, not only that something valuable is preserved when we level down, but also that preserving it may be, in certain circumstances, preferable to pursuing other fundamental moral goals. Although troublesome from a well-being maximising standpoint, levelling down ensures that healthcare policy reflects a commitment with the idea that people are equal in moral worth. That commitment is important enough to trump certain improvements in individual well-being. In the case of pandemic lockdowns, not all the interests protected by free movement are as fundamental as to pursue them at the cost of equality. Savulescu and Cameron's framework is so reliant on the view that levelling down is wrong that it fails to account for the valuable loss that having the elderly suffer alone represents.

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来源期刊
Journal of Medical Ethics
Journal of Medical Ethics 医学-医学:伦理
CiteScore
7.80
自引率
9.80%
发文量
164
审稿时长
4-8 weeks
期刊介绍: Journal of Medical Ethics is a leading international journal that reflects the whole field of medical ethics. The journal seeks to promote ethical reflection and conduct in scientific research and medical practice. It features articles on various ethical aspects of health care relevant to health care professionals, members of clinical ethics committees, medical ethics professionals, researchers and bioscientists, policy makers and patients. Subscribers to the Journal of Medical Ethics also receive Medical Humanities journal at no extra cost. JME is the official journal of the Institute of Medical Ethics.
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