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    Please use this identifier to cite or link to this item: http://ir.lib.ncu.edu.tw/handle/987654321/4592


    Title: 長期照護的倫理基礎;The Ethics of Long-Term Care
    Authors: 蔣欽堯;Chin-Yao Chiang
    Contributors: 哲學研究所碩士在職專班
    Keywords: 長期照護;健康照護;羅爾斯;丹尼爾斯;long-term care;health care;John Rawls;Norman Daniels
    Date: 2009-06-19
    Issue Date: 2009-09-22 09:27:47 (UTC+8)
    Publisher: 國立中央大學圖書館
    Abstract: 二十一世紀的人口結構使得長期照護成為重要的社會問題,而且這個問題的重要性正在與日俱增。台灣地區在未來十年將面臨四百萬的老年人口,而其中有約有四十萬人需要接受長期照護。許多對長期照護政策的討論一直環繞在長期照護的責任歸屬,是否長期照護是個人和家庭的問題,還是整體社會應該為這些失能者提供照護和服務。有些觀點認為長期照護應該是個人和家庭的責任,只有當個人和家庭無法提供這些服務時,政府才扮演最後的救援工作。 為釐清長期照護的責任歸屬,本文藉由丹尼爾斯的正義健康照護理論來說明長期照護的重要,以及社會正義與長期照護的關係,並且說明長期照護的資源分配也必須兼顧其他各項公共支出。丹尼爾斯的正義健康照護理論主要說明健康在道德上的重要性、健康與社會正義的關係以及在資源有限下如何進行資源的分配。在丹尼爾斯的正義健康照護理論中,對健康的維護不僅包含急症的治療與預防,也包含長期照護,這些項目都是為了維護正常物種功能的行使。羅爾斯指出丹尼爾斯的正義健康照護理論是對羅爾斯正義理論的進一步發展;因此本文援引羅爾斯的正義理論來說明社會正義與健康的關係。社會必需是世代相繼公平合作的體系,為了維護這種體系的存在,必須有社會正義原則來作為支柱,以確保所有人都能對於生活有合理的期待;而健康作為維護人類生活的重要項目,就必須得到社會正義的重視與支持。 長期照護需要耗用大量的社會資源,而且某些長期照護的費用可能是災難性的昂貴。對人們而言,如何得到保護以避免在失去健康和財務潦倒之間做出選擇,是至關重要。健康照護體系所肩負的責任不僅是改善人們的健康,也要保護他們免於疾病所引起的財務損失,和降低對自尊和自律的損害、以及疾病所帶來的恐懼和恥辱,並且尊嚴地得到照護。對於長期照護的提供不只是個別家庭的責任,也是社會整體的責任。社會也必須同時保障個人在與年齡相關的機會範圍得到公平的待遇,所以在每一個生命階段中社會都有義務促進個人正常功能的行使;然而,這種保障個人機會範圍的制度也必需是可持續,而且也必須公平地對待不同出生年代的團體,以保障所有人都能有機會得到基本的照護。 Long-term care has become an emergent social problem in the 21st century. In ten years, there are going to be four million elder people in Taiwan and four hundred thousand of them will be in need of the service of long-term care. The main issue of long-term care is about whose responsibility of providing this service. Is it a problem to be solved in one’s family or should the whole society have the duty to take charge? Some people assign the primary responsibility of care to individuals and their families and insist that government should act only as the last payer for those unable to provide for themselves. Proponents of this view generally oppose giving aid to caregivers and denounce the aid to family would undesirably monetize family caring relationships. This thesis follows Norman Daniels’ theory of just health care to give an answer to this question about who should take the responsibility. Daniels points out three important aspects of just health care: the moral importance of health care, the relation between health and social justice and the scarce resource relocation. Daniels’ just health theory can well give us a good answer to the long term care because long term care is also an important branch of health care. Since Daniels develops the just health theory from John Rawls’ just theory, this thesis also make an attempt to explicate Rawls’ main concept about a just society. Long-term care can consume a great amount of social resource and the prices of some kinds of long-term care service could soar to the skies. The public health care system should not only improve public health but also have to protect people from the deprivation caused by illness. The responsibility of providing of long-term care service falls on both the individual family and the society as a whole. The aid from government to support long-term care is just like the aid given to public education or relief payment for those involuntarily out of work. This is not a waste of social resource but a practice of social justice. The social justice should guarantee the range of fair equality of opportunity. So each stage of life span has to be put into the same consideration. To ensure everyone can have access to the basic health care and long term care, it is both moral and reasonable to set the limits of providing care. Without the limits, long-term care could exhaust the scarce social resource and cause a greater disaster.
    Appears in Collections:[哲學研究所碩士在職專班 ] 博碩士論文

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