希少な医療資源を配分するための共同の倫理的枠組み:COVID-19からの教訓
Ezekiel J Emanuel1, Govind Persad2
1Healthcare Transformation Institute, Department of Medical Ethics & Health Policy, Perelman School of Medicine and Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
Lancet (London, England)
|May 12, 2023
まとめ
COVID-19 パンデミックは,希少な医療資源の配分のための倫理的枠組みを強調しました. 倫理的なアプローチには 価値観,優先順位,公正な実施が含まれており 健康危機の際に 公平な分配を保証します
科学分野:
- 医学 の 倫理
- 公衆衛生政策
- 資源配分
背景:
- COVID-19 パンデミックは,世界的に希少な医療資源の公平な配分に伴う課題を強調しました.
- 倫理的な割り当てには,価値観,優先順位設定,実行を含む構造的なアプローチが必要です.
研究 の 目的:
- 限られた医療資源の配分のための3段階の倫理的枠組みを概説する.
- 資源分配の基本的倫理的価値と手続きの原則を特定する.
- COVID-19 パンデミックの間,これらの原則の適用と実施を分析する.
主な方法:
- 資源の配分に関する基本的な倫理的価値観の明確化
- 倫理的な価値観に基づいて優先順位を決めること
- 実施プロセスの評価と課題の特定
主要な成果:
- 利益の最大化,害の最小化,不利な状況の緩和,平等な関心,相互性といった 5つの本質的な価値観が特定されました.
- 手続きの原則には,透明性,関与,証拠への反応が含まれています.
- COVID-19の配分は,医療従事者,ファーストレスポンダー,脆弱な集団を優先したが,受動的配分や人口ベースの配分などの実施問題も指摘された.
結論:
- 提案された倫理的枠組みは,パンデミックや公衆衛生上の緊急事態における 希少な医療資源の将来的な配分を導くべきである.
- マラリアワクチンのような将来的な配分では,特に脆弱な集団の重篤な病気と死亡を減らすことが優先されるべきです.
- 資源の公平な分配には 実施の課題に取り組むことが不可欠です
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