Dwyer J, Tsai D F-C
SUNY Upstate Medical University, Center for Bioethics and Humanities, 725 Irving Avenue, Suite 406, Syracuse, NY 13210, USA.
J Med Ethics. 2008 Jan;34(1):7-10. doi: 10.1136/jme.2006.018978.
SARS, like HIV, placed healthcare workers at risk and raised issues about the duty to treat. But philosophical accounts of the duty to treat that were developed in the context of HIV did not adequately address some of the ethical issues raised by SARS. Since the next epidemic may be more like SARS than HIV, it is important to illuminate these issues. In this paper, we sketch a general account of the duty to treat that arose in response to HIV. Our purpose is not to defend or criticise this account, but to show that it needs to be developed in order to address three important issues. The first issue concerns how risks should be distributed among healthcare professionals. The second issue concerns the conflicts that arise between professional duties and family duties. The third issue concerns the forms of support that societies owe healthcare workers during epidemics. Our descriptions of these issues are drawn from our experience of the SARS epidemic in Taiwan.
严重急性呼吸综合征(SARS)与人类免疫缺陷病毒(HIV)一样,使医护人员面临风险,并引发了关于治疗义务的问题。但是,在HIV背景下形成的治疗义务的哲学阐释,并未充分解决SARS引发的一些伦理问题。由于下一次疫情可能更像SARS而非HIV,阐明这些问题很重要。在本文中,我们概述了针对HIV而产生的治疗义务的一般阐释。我们的目的不是捍卫或批评这一阐释,而是表明需要对其进行拓展,以解决三个重要问题。第一个问题涉及风险应如何在医护专业人员中分配。第二个问题涉及职业道德与家庭责任之间产生的冲突。第三个问题涉及社会在疫情期间对医护人员应提供的支持形式。我们对这些问题的描述取材于我们在台湾SARS疫情中的经历。