Anantham Devanand, McHugh Wendy, O'Neill Stephen, Forrow Lachlan
Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Duke-NUS Graduate Medical School, Outram Road, Singapore 169608, Singapore.
Crit Care. 2008;12(3):217. doi: 10.1186/cc6918. Epub 2008 Jun 24.
An influenza pandemic threatens to be the most lethal public health crisis to confront the world. Physicians will have critical roles in diagnosis, containment and treatment of influenza, and their commitment to treat despite increased personal risks is essential for a successful public health response. The obligations of the medical profession stem from the unique skills of its practitioners, who are able to provide more effective aid than the general public in a medical emergency. The free choice of profession and the societal contract from which doctors derive substantial benefits affirm this commitment. In hospitals, the duty will fall upon specialties that are most qualified to deal with an influenza pandemic, such as critical care, pulmonology, anesthesiology and emergency medicine. It is unrealistic to expect that this obligation to treat should be burdened with unlimited risks. Instead, risks should be minimized and justified against the effectiveness of interventions. Institutional and public cooperation in logistics, remuneration and psychological/legal support may help remove the barriers to the ability to treat. By stepping forward in duty during such a pandemic, physicians will be able to reaffirm the ethical center of the profession and lead the rest of the healthcare team in overcoming the medical crisis.
流感大流行可能成为全球面临的最致命的公共卫生危机。医生在流感的诊断、控制和治疗中起着关键作用,他们不顾个人风险增加而坚持治疗,对于成功应对公共卫生危机至关重要。医学 profession 的义务源于其从业者的独特技能,在医疗紧急情况下,他们能够比普通公众提供更有效的援助。职业的自由选择以及医生从中获得巨大利益的社会契约证实了这一承诺。在医院里,责任将落在最有资格应对流感大流行的专科上,如重症监护、肺病学、麻醉学和急诊医学。期望这种治疗义务承担无限风险是不现实的。相反,应将风险降至最低,并根据干预措施的有效性进行合理评估。机构和公众在后勤、薪酬以及心理/法律支持方面的合作,可能有助于消除治疗能力的障碍。在这样的大流行期间履行职责,医生将能够重申该职业的道德核心,并带领医疗团队的其他成员克服医疗危机。
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