分配稀缺医疗资源的共同道德框架:从COVID-19中吸取的教训
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
概括
COVID-19 疫情凸显了医疗资源稀缺的道德框架. 伦理方法涉及价值观,优先级和公平实施, 以确保卫生危机期间的公平分配.
科学领域:
- 医学伦理
- 公共卫生政策
- 资源分配
背景情况:
- COVID-19 疫情凸显了全球稀缺医疗资源公平分配的挑战.
- 伦理分配需要一个结构化的方法,包括价值观,优先设定和实施.
研究的目的:
- 为分配稀缺的医疗资源制定一个三步道德框架.
- 确定资源分配的核心伦理价值和程序原则.
- 在COVID-19疫情期间分析这些原则的应用和实施.
主要方法:
- 阐明资源分配的基本道德价值观.
- 基于道德价值的优先级划分.
- 评估实施过程并确定挑战.
主要成果:
- 确定了五个核心实质价值观:最大限度地获益,最大限度地减少伤害,减轻劣势,平等关注和互惠.
- 程序原则包括透明度,参与度和对证据的敏感性.
- 在COVID-19分配中,优先考虑医疗保健工作者,急救人员和弱势群体,但注意到被动分配和基于人口的分配等实施问题.
结论:
- 拟议的伦理框架应指导未来在流行病和公共卫生紧急情况中分配稀缺的医疗资源.
- 未来的拨款,如疟疾疫苗,应优先减少严重疾病和死亡,特别是在弱势群体中.
- 应对实施挑战对于公平的资源分配至关重要.
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