Bensimon Cécile M, Upshur Ross E G
Joint Centre for Bioethics and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Am J Public Health. 2007 Apr;97 Suppl 1(Suppl 1):S44-8. doi: 10.2105/AJPH.2005.077305. Epub 2007 Apr 5.
When public health decisionmakers turned to quarantine during the recent severe acute respiratory syndrome (SARS) epidemic, difficult questions were raised about the legitimacy and acceptability of restrictive measures to attain public health goals. SARS also brought to light how scientific uncertainty can permeate public health decisionmaking, leading us to think about the relationship between the adequacy of evidence of the effectiveness of an intervention and its role in the justification of public health action. In this article, we critically examine the role of evidence and effectiveness in decision-making for quarantine. It is our contention that the effectiveness of a public health intervention should not be defined exclusively in (absolute and objective) scientific terms but rather conceptualized relationally and normatively in public health decisionmaking.
在近期严重急性呼吸综合征（SARS）疫情期间，当公共卫生决策者采用隔离措施时，关于为实现公共卫生目标而采取的限制措施的合法性和可接受性出现了难题。SARS还揭示了科学的不确定性是如何渗透到公共卫生决策过程中的，促使我们思考干预措施有效性证据的充分性与其在证明公共卫生行动合理性方面的作用之间的关系。在本文中，我们批判性地审视了证据和有效性在隔离决策中的作用。我们认为，公共卫生干预措施的有效性不应仅以（绝对和客观的）科学术语来定义，而应在公共卫生决策中从关系和规范的角度进行概念化。
