卫生服务公平性:理念、制度和实践——读《关于深化医药卫生体制改革的意见(征求意见稿)》有感

长期以来,我国的卫生服务一直存在着不公平的状况,看病难、看病贵等问题在农村表现十分突出,一直是社会关注的焦点。对卫生服务不公平问题的讨论也已经持续很久,正因为如此,人们对新一轮的卫生体制改革寄予厚望。人们深知,实现卫生服务公平性需要从理念转变到人、财、物的支持,从构建相应的制度、机制、法规到付诸实践等多方面着手,只有这样才能实现人人享有卫生保健的目标。     

生命权利平等的伦理诠释

人的生命是十分珍贵的,生命权利应该优先于一切权利。没有先进的医学技术和较高的社会发展水平,生命权利就很难得到保障和实现。在发展医学技术的同时,应认真思考卫生经济政策的核心价值,保证卫生经济政策在任何时候都不背离公民的健康利益,从而保障人的生命权利得以实现。     

Rethinking Accountability in the Context of Human Rights

Within liberal democratic theory, ‘democratic accountability’ denotes an aggregative method for linking political decisions to citizens’ preferences through representative institutions. Could such a notion be transferred to the global context of human rights? Various obstacles seem to block such a transfer: there are no ‘world citizens’ as such; many people in need of human rights are not citizens of constitutional democratic states; and the aggregative methods that are supposed to sustain the link are often used in favour of nation-state strategic action rather than human rights. So what could accountability mean in relation to human rights? This article argues that discourse theory offers resources for approaching these problems and for rethinking a normative notion of accountability in relation to human rights. It is suggested that accountability should link political decisions to universal agreements through global rights institutions and that the link should be sustained by deliberative rather than aggregative procedures.     

Following the Path to Equality Through Law: Reflections on Baker et al., <Emphasis Type="Italic">Equality: from Theory to Action</Emphasis>

This article assesses the significance of Baker et al., Equality: from Theory to Action from the perspective of current concerns occupying legal equality scholars in the UK, focusing in particular on the practical relevance of equality studies to the kinds of issues arising from the debate over the new Commission for Equality and Human Rights (CEHR). The article highlights and considers key issues, including the delineation of the sphere of inequality protection, the normative content of the concept of equality espoused by law and the potential of law to reach beyond its current limits to embrace the broader dimensions of (in)equality identified in Baker et al.’s account.     

Equality of opportunity and complex equality: The special place of schooling

This paper is an engagement with Equality by John Baker, Kathleen Lynch, Judy Walsh and Sara Cantillon. It identifies a dilemma for educational egalitarians, which arises within their theory of equality, arguing that sometimes there may be a conflict between advancing equality of opportunity and providing equality of respect and recognition, and equality of love care and solidarity. It argues that the latter values may have more weight in deciding what to do than traditional educational egalitarians have usually thought.     

医疗决策的程序公正

由于社会满足不了所有的医疗需求,医疗决策问题变成了确定医疗的限度问题。由于社会对于限度决定很难获得共识,医疗决策要通过公正的程序获得。医疗决策不能由某个人或某个团体或权力机构做出,而应该通过民主协商来做出,否则,人们会质疑医疗决策的合法性。     

THE CAPABILITIES OF PEOPLE WITH COGNITIVE DISABILITIES

Abstract: People with cognitive disabilities are equal citizens, and law ought to show respect for them as full equals. To do so, law must provide such people with equal entitlements to medical care, housing, and other economic needs. But law must also go further, providing people with disabilities truly equal access to education, even when that is costly and involves considerable change in current methods of instruction. The central theme of this essay is what is required in order to give such people political and civil rights on a basis of genuine equality.     

社会支配倾向研究述评

社会支配倾向是社会支配理论中的一个概念,它反映了个体期望内群体优于和支配外群体的程度。高社会支配倾向者偏好加大不同群体间的阶层差异,并期望优势群体更多地支配劣势群体;低社会支配倾向者偏好缩小不同群体间的阶层差异以增加社会平等,并期望优势群体更少地支配劣势群体。因此,社会支配倾向会影响社会不平等的程度,并可以被用来解释偏见的形成。性别和群体地位等情境因素会对社会支配倾向产生影响,而且社会支配倾向与个体间的支配也是有关系的     

The Global Scope of Justice

In this paper, I examine the question of the scope of justice, in a not unusual distributive, egalitarian, and universalistic framework. Part I outlines some central features of the egalitarian theory of justice I am proposing. According to such a conception, justice is – at least prima facie – immediately universal, and therefore global. It does not morally recognize any judicial boundaries or limits. Part II examines whether, even from a universalistic perspective, there are moral or pragmatic grounds for rejecting or limiting the global scope of justice. In particular, I scrutinize five universalistic objections: (1) the principle of "moral division of labor"; (2) the connection between cooperation and distributive justice; (3) the primacy of democracy; (4) the dangers of a world state; and (5) political-pragmatic reasons. I intend to show that these objections cannot undermine the strong normative claims of global justice. At the most, political-pragmatic reasons speak in favor of initially striving for somewhat less, in order to receive more general backing.     

Are Nativists a Different Kind of Democrat? Democratic Values and “Outsiders” in Japan

This paper combines three elements: a discussion of democratic values and the status of outsiders in Japanese political culture, the development of new measures to examine sensitive issues of nativism and foreigner perception in Japan, and an empirical exploration of the relationship between democratic values and antipathy toward outsiders. Two forms of democratic orientation were investigated in a sample of about 1,000 university students in Japan: a defensive version, which adheres to the formalistic requirements of democracy but is exclusionary and illiberal, and a universalist version that is liberal and tolerant. A defensive orientation is associated with greater chauvinism, a greater sense of threat emanating from foreigners, and a heightened anxiety about economic competition. A universalist orientation is associated with low perceived threat and low chauvinism, a lack of fear of economic competition, and a positive view of the cultural contributions of outsiders. Nativism may indeed be compatible with democratic values, but only with the defensive, exclusionary form. In short, the defensive form is democracy for xenophobes. Such an orientation is not unique to Japan, but is likely to be found in developing democracies as well as in advanced democracies that feel threatened.