Stark R, Nair N V, Omi S
World Health Organization, Manila, Philippines.
Nurs Ethics. 1999 Jul;6(4):273-7. doi: 10.1177/096973309900600402.
One of the principles of health care ethics is the principle of justice. An important expression of justice is equity. The provision of basic primary health care services to all people is the key to eliminating the gross inequities in health status existing in many countries. For many years nurses in developing countries have 'led the way' in bringing these essential services to poor rural communities, including the diagnosis and treatment of illnesses, and the prescribing and dispensing of medications. Nurses are the most appropriate health workers for this role, but most have not been prepared adequately for it. This is unsafe for patients and puts nurses at legal risk. Justice requires that patients should obtain access to safe health care and that nurses should receive appropriate education. Nurse practitioner programmes are being established to prepare nurses for this advanced practice role, but here again ethical considerations apply. Justice will be served only if nurse practitioner programmes are accessible to the nurses who are most likely to work in medically underserved communities where the need is greatest.
医疗保健伦理原则之一是公正原则。公正的一个重要体现是公平。为所有人提供基本的初级卫生保健服务是消除许多国家存在的健康状况严重不平等现象的关键。多年来，发展中国家的护士在将这些基本服务带给贫困农村社区方面“走在了前列”，包括疾病的诊断和治疗以及药物的开方和配药。护士是担任这一角色最合适的卫生工作者，但大多数护士并未为此做好充分准备。这对患者不安全，也使护士面临法律风险。公正要求患者应能获得安全的医疗保健，护士应接受适当的教育。正在设立执业护士培训项目，以使护士胜任这一高级实践角色，但在此同样适用伦理考量。只有最有可能在医疗服务最欠缺且需求最大的社区工作的护士能够参加执业护士培训项目，公正才能得以实现。
