O'Laughlin Daniel T, Hick John L
Emergency Medicine Department, Abbott Northwestern Hospital, 800 E 28th Street, Minneapolis MN 55407, USA.
Respir Care. 2008 Feb;53(2):190-7; discussion 197-200.
Mass-care events, such as pandemic influenza, could reach such devastating proportions that there will be the need to make difficult triage decisions that will ultimately result in the deaths or severe disability of patients in large numbers. The method by which we determine how triage of scarce health care resources will be performed must be clearly defined prior to a disaster event. This paper will discuss several of the ethical principles that must be weighed in developing a mass-care triage plan, as well as steps to facilitate its implementation. Development of triage policies in such an event should be developed in an open and transparent manner, be reasonable in design, include the views of the critical stakeholders, and be responsive to and provide a mechanism for accountability, with a clearly defined goal of the just triage of limited health care resources. Planning failure will result in increased deaths from poor triage processes and substantial mistrust of the health care system and its practitioners.
大规模照护事件，如大流行性流感，可能会达到极其严重的程度，以至于需要做出艰难的分诊决策，而这最终将导致大量患者死亡或严重残疾。我们必须在灾难事件发生之前明确确定如何进行稀缺医疗资源的分诊。本文将讨论在制定大规模照护分诊计划时必须权衡的若干伦理原则，以及促进其实施的步骤。在这类事件中制定分诊政策应以公开透明的方式进行，设计合理，纳入关键利益相关者的意见，并具备问责机制且能做出响应，明确有限医疗资源公正分诊的目标。规划失败将导致因分诊流程不佳而增加死亡人数，以及对医疗系统及其从业者的严重不信任。
