结合分配伦理和因果推断在紧缩和人口健康之间进行权衡
Combining distributive ethics and causal Inference to make trade-offs between austerity and population health
摘要：
国际货币基金组织（IMF）向陷入经济动荡的成员国提供财政援助，但同时要求这些国家改革公共政策。在一些情况下，这些改革与人口健康不一致。虽然研究人员已经从经验上分析了这些改革对健康的影响，但没有分析确定对人口健康和经济成果的影响之间的公平权衡。我们的文章分析并确定了这些权衡的原则。首先，本文回顾了现有的政策评估研究，这些研究表明，总的来说，国际货币基金组织的政策经常对儿童健康和物质标准造成不利影响，以追求宏观经济的改善。其次，本文讨论了分配伦理学中的四种理论（最大化、平等主义、优先主义和非均衡主义），以确定哪一种理论最符合IMF的核心使命，即改善宏观经济学（《协议条款》），同时平衡对健康的影响。使用分配伦理分析的国际货币基金组织的政策，我们认为，自愿主义是最兼容的理论。第三，本文提供了一个定性的重新阐明的协议条款，并正式的因果推断的语言的基本原则。我们还提供了一个框架，说明如何从观察数据中实证衡量国际货币基金组织政策在人口健康和经济成果之间公平权衡的程度。最后，我们提出了政策建议和未来研究的建议。
英文摘要：
The International Monetary Fund (IMF) provides financial assistance to its member-countries in economic turmoil, but requires at the same time that these countries reform their public policies. In several contexts, these reforms are at odds with population health. While researchers have empirically analyzed the consequences of these reforms on health, no analysis exist on identifying fair tradeoffs between consequences on population health and economic outcomes. Our article analyzes and identifies the principles governing these tradeoffs. First, this article reviews existing policy-evaluation studies, which show, on balance, that IMF policies frequently cause adverse effects on child health and material standards in the pursuit of macroeconmic improvement. Second, this article discusses four theories in distributive ethics (maximization, egalitarianianism, prioritarianiasm, and sufficientarianism) to identify which is the most compatible with the core mission of the IMF, that is, improved macroeconomics (Articles of Agreement) while at the same time balancing consequences on health. Using a distributive-ethics analyses of IMF polices, we argue that sufficientarianism is the most compatible theory. Third, this article offer a qualitative rearticulation of the Articles of Agreement, and formalize sufficientarian principles in the language of causal inference. We also offer a framework on how to empirically measure, from observational data, the extent that IMF policies trade off fairly between population health and economic outcomes. We conclude with policy recommendations and suggestions for future research.
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