主动健康中个人自主与公共责任的伦理张力  

The Ethical Tension between Individual Autonomy and Public Responsibility in Proactive Health

作　　者：陈旻[1,2,3] CHEN Min(School of Health Management,Fujian Medical University,Fuzhou 350122,China;Research Centre for Medical Humanities,Fujian Medical University,Fuzhou 350122,China;Fujian Research Association for Medical and Health System Reform,Fuzhou 350122,China)

机构地区：[1]福建医科大学卫生管理学院,福建福州350122 [2]福建医科大学医学人文研究中心,福建福州350122 [3]福建省医药卫生体制改革研究会,福建福州350122

出　　处：《医学与哲学》2025年第5期6-11,共6页Medicine and Philosophy

基　　金：2023年国家社会科学基金一般项目(23BSH096)。

摘　　要：首先,讨论个人自主权与公共健康责任的伦理博弈,包括医学伦理四原则在健康责任分配中的体现,以及个人主义与社群主义理念的冲突。其次,考察健康的社会决定因素如何导致弱势群体在健康方面处于不利地位,探讨片面强调个人责任可能加剧的健康不平等问题。再次,以我国长期护理保险政策为例,分析该政策如何在实践中平衡个人自主与社会支持。最后,提出可能的伦理路径修正与政策建议,倡导从“问责个体”转向“系统赋能”,以实现更加公正和包容的“健康中国”战略。First,it discusses the ethical struggle between individual autonomy and public health responsibility,including the manifestation of the four principles of medical ethics in the allocation of health responsibilities,and the conflict between individualism and communitarianism.Second,it examines how social determinants of health place vulnerable groups at a disadvantage in terms of health,exploring the potential exacerbation of health inequalities by an excessive emphasis on individual responsibility.Next,using China's long-term care insurance policy as an example,the paper analyzes how this policy balances individual autonomy and social support in practice.Finally,possible ethical pathways and policy recommendations are proposed,advocating for a shift from"individual accountability"to"systemic empowerment",to achieve a more just and inclusive"Healthy China"strategy.

关 键 词：主动健康 个人自主 公共责任 伦理张力 长期护理保险 

分 类 号：R-05[医药卫生]