Abstract：
Principles for priority setting in health care are typically forged by experts influenced by the normative literature on priority setting. Meanwhile, their implementation is subject to democratic deliberation, political pressures, and administrative bureaucracy. Sometimes expert proposals are democratically rejected. This points towards a problem: on the one hand, the fact that a majority shares a moral belief does not inherently validate this belief. On the other hand, when justifying a position to others, we cannot expect much success without engaging with their moral judgments. In this work we examine the possibility of including so-called popular views in a reflective equilibrium process. In reflective equilibrium processes, we are usually interested in considered judgments rather than mere intuitions. Popular views, arguably, often do not meet this standard. To mitigate this, we propose to bolster popular views by linking them with theoretical frameworks echoing similar moral perspectives. We use illness severity as a case study and show that a set of popular accounts can provide considered judgments that merit inclusion in a publicly informed reflective equilibrium process. This is plausibly a way forward in the search for priority setting principles that are both normatively sound and acceptable to the public. Our method provides a general framework for refining available data on popular views on moral questions, including when we cannot assess the consideredness of such views.
摘要：
医疗保健中优先级设置的原则通常是由受有关优先级设置的规范性文献影响的专家制定的。同时,它们的实施需要民主审议，政治压力,行政官僚主义。有时专家建议被民主拒绝。这就指向了一个问题:一方面,大多数人分享道德信仰的事实并不能固有地证实这种信仰。另一方面,在为他人辩护时，如果不参与他们的道德判断，我们就不能指望成功。在这项工作中，我们研究了在反射平衡过程中包含所谓的流行观点的可能性。在反射平衡过程中，我们通常对经过深思熟虑的判断感兴趣，而不仅仅是直觉。热门观点,可以说,往往达不到这个标准。为了缓解这种情况，我们建议通过将流行观点与呼应类似道德观点的理论框架联系起来来支持流行观点。我们使用疾病严重程度作为案例研究，并表明一组受欢迎的帐户可以提供值得考虑的判断，值得纳入公开知情的反思平衡过程。这似乎是寻求既规范合理又为公众所接受的优先原则的前进道路。我们的方法提供了一个通用框架，用于完善有关道德问题的流行观点的可用数据，包括当我们无法评估这些观点的考虑时。
