Several ethicists have defended the use of responsibility-based criteria in healthcare rationing. Yet in this article we outline two challenges to the implementation of responsibility-based healthcare rationing policies. These two challenges are, namely, that responsibility for past behavior can diminish as an agent changes, and that blame can come apart from responsibility. These challenges suggest that it is more difficult to hold someone responsible for health related actions than proponents of responsibility-sensitive healthcare policies suggest. We close by discussing public health policies that could function as an alternative to contentious, responsibility-sensitive rationing policies.

中文翻译：

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配给，责任和责备：对医疗保健配给责任敏感政策的道德评估。

一些伦理学家为在医疗保健配给中使用基于责任的标准辩护。然而，在本文中，我们概述了实施基于责任的医疗保健配给政策的两个挑战。这两个挑战是，随着代理人的变化，对过去行为的责任可能会减少，而责备也可能与责任分开。这些挑战表明，比起对责任敏感的医疗保健政策的支持者，要让一个人对与健康相关的行为负责任更加困难。最后，我们讨论公共卫生政策，该政策可以替代有争议的，对责任敏感的配给政策。