論搭配否決權的按年齡配給

On Age Rationing Combined With the Veto Right

林耕漢(Keng-Han Lin)

《政治與社會哲學評論》 71期 (2019/12) Pp. 1-50

https://doi.org/10.6523/SOCIETAS.201912_(71).001

摘要

老年人對醫療照護資源的高度需求已經對公共的健康照護體系形成了負擔。在某種程度上，這造成了世代間分配正義的問題。有鑑於此，已經有許多學者建議社會應該限制老年人獲取某些醫療資源，這樣的主張被稱為是按年齡配給（age rationing）；並且，丹尼爾斯（Norman Daniels）以謹慎壽命論述（the prudential lifespan account）來支持這項主張。依據這項論述，謹慎且理性的人會分配較少的醫療資源給老年時的自己。由於這是個人自己的決定，因此這就展現了對老年人的尊重，同時又能為年輕人節省更多的醫療資源。然而，本文將指出謹慎壽命論述依然有不夠尊重老年人的問題。為了展現對所有人的尊重，我們應該讓按年齡配給搭配否決權。

關鍵字

老年人 ； 健康照護 ； 按年齡配給 ； 分配正義 ； 世代正義

並列摘要

The high demand for medical care resources for the elderly has placed a burden on the public health care system. To a certain extent, this is a problem of distributive justice between generations. In view of this, many scholars have suggested that society should limit the elderly's access to certain medical resources, which is called age rationing. Norman Daniels supports this suggestion by using the prudential lifespan account, according to which, a prudent and rational person will allocate fewer medical resources to himself in old age. Since this is an individual's own decision, this demonstrates respect for old people while saving more medical resources for young people. However, this article will point out that the prudential lifespan account is still not enough to ensure respect for the elderly. In order to show respect for everyone, we should combine age rationing with the veto right.

並列關鍵字

the elderly ； health care ； age rationing ； distributive justice ； generational justice

參考文獻

Brauer, Susanne. 2009.“Age Rationing and Prudential Lifespan Account in Norman Daniels,” Journal of Medical Ethics 35: 27-31.

Callahan, Daniel. 2012. “Must We Ration Health Care for the Elderly?” Journal of Law, Medicine & Ethics 40(1): 10-16.

Cavallero, Eric. 2011. “Health, Luck and Moral Fallacies of the Second Best,” Journal of Ethics 15: 387- 403.

Engster, Daniel. 2015. Justice, Care, and the Welfare State. Oxford: Oxford University.

Jaworska, Agnieszka. 1999. “Respecting the Margins of Agency: Alzheimer's Patients and the Capacity to Value,” Philosophy and Public Affairs 28(2): 105-138.