Schuklenk U, Gartland K M A
Centre for Ethics in Public Policy and Corporate Governance, Glasgow Caledonian University, Glasgow G4 0BA, Scotland, UK.
Biochem Soc Trans. 2006 Dec;34(Pt 6):1151-4. doi: 10.1042/BST0341151.
The prolonged concern over the potential for a global influenza pandemic to cause perhaps many millions of fatalities is a chilling one. After the SARS (severe acute respiratory syndrome) scares [1], attention has turned towards the possibility of an avian influenza virus hybridizing with a human influenza virus to create a highly virulent, as yet unknown, killer, on a scale unseen since the Spanish flu outbreak of 1918, which produced more fatalities than the Great War. In deciding how countries should react to this potential pandemic, individually and collectively, a reasonable and practical balance must be struck between the rights and obligations of individual citizens and protection of the wider community and, indeed, society as a whole. In this communication, ethical issues are discussed in the context of some of the scientific questions relating to a potential influenza pandemic. Among these issues are the rights and obligations of healthcare professionals, difficulties surrounding resource allocation, policies that have an impact on liberty and trade, when and how to introduce any vaccine or other form of mass treatment, global governance questions and the role of health policies in contemporary society. By considering these issues and questions in advance of an influenza, or indeed any other, pandemic commencing, countries can be better prepared to deal with the inevitably difficult decisions required during such events, rather than dusting down outdated previous plans, or making and implementing policy in an ad hoc manner with a resultant higher risk of adverse consequences.
长期以来，人们一直担心全球流感大流行可能导致数百万人死亡，这令人不寒而栗。在经历了非典（严重急性呼吸综合征）恐慌之后[1]，注意力已转向禽流感病毒与人类流感病毒杂交，从而产生一种高致病性、尚不为人知的杀手病毒的可能性，其规模自1918年西班牙流感爆发以来未见，那次流感造成的死亡人数超过了第一次世界大战。在决定各国应如何单独和集体应对这一潜在的大流行时，必须在公民个人的权利和义务与更广泛社区乃至整个社会的保护之间达成合理而实际的平衡。在本通讯中，将在一些与潜在流感大流行相关的科学问题背景下讨论伦理问题。这些问题包括医护人员的权利和义务、资源分配方面的困难、对自由和贸易有影响的政策、何时以及如何推出任何疫苗或其他形式的大规模治疗、全球治理问题以及卫生政策在当代社会中的作用。通过在流感或其他任何大流行开始之前就考虑这些问题，各国能够更好地准备应对此类事件期间不可避免的艰难决策，而不是翻出过时的先前计划，或以临时方式制定和实施政策，从而带来更高的不良后果风险。
