运气平等主义与吸烟者的健康责任  

Luck Egalitarianism and the Health Responsibility of Smokers

作　　者：杨睿轩 YANG Ruixuan(School of Marxism,Shandong Huayu University of Technology,Dezhou 253034,China)

机构地区：[1]山东华宇工学院马克思主义学院,山东德州253034

出　　处：《医学与哲学》2024年第17期16-21,共6页Medicine and Philosophy

基　　金：2023年山东省哲学社会科学青年人才团队项目(2023-zkzd-105)。

摘　　要：作为一种以责任为导向的分配正义理论,运气平等主义主张吸烟者应自行承担自愿选择吸烟而造成的医疗成本责任,否则会对其他人不公平。吸烟者健康责任论虽然在道德直觉上极具吸引力,但却面临实践上的困难。以前瞻性责任为依据的事前投保或征税方案,可能遭遇道德风险或不能精准锁定目标人群等问题。以追溯性责任为依据的“罚当其责”方案,可能面临认识论或医学伦理等问题。从次优角度来看,以激励和预防为主的前瞻性责任比以指责和惩罚为主的追溯性责任更能产生促进健康的效果。As a theory of distributive justice oriented towards responsibility,luck egalitarianism asserts that smokers should bear the medical costs resulting from their voluntary choice to smoke,otherwise,it would be unfair to others.The smoker's health responsibility theory,although morally compelling,faces practical difficulties.Pre-emptive insurance or taxation schemes based on prospective responsibility may encounter problems such as moral hazard or the inability to accurately target the intended population.Punitive schemes based on retrospective responsibility may face epistemological or medical ethics challenges.From a second-best perspective,prospective responsibility,which emphasizes incentives and prevention,is more likely to promote health outcomes than retrospective responsibility,which focuses on blame and punishment.

关 键 词：吸烟者 运气平等主义 健康 前瞻性责任 追溯性责任 

分 类 号：R-05[医药卫生]