高額長期疾病の医療費補助制度における倫理的問題

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  • Ethical Issues Concerning the Subsidy System for Patients with Special Diseases
  • コウガク チョウキ シッペイ ノ イリョウヒ ホジョ セイド ニ オケル リンリテキ モンダイ

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Patients requiring high-cost and long-term medical treatment are eligible for financial assistance in Japan. There are three categories of illness according to which the benefits differ: special diseases, intractable diseases, and others. The purpose of this paper is to shed light on some ethical issues concerning the first group which consists of hemophilia, chronic renal failure requiring dialysis, and HIV/AIDS transmitted through contaminated blood products. First, there are no tenable explanations as to why these conditions are special enough to deserve the most generous financial support. Second, the system discriminates against those patients who have contracted HIV for reasons other than those stipulated. Third, hemophiliacs have to pay nothing for their treatments, no matter how exorbitant the expenses are. The opportunity costs should be taken into account to make the subsidy system both fair and sustainable.

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