Barnett Daniel J, Taylor Holly A, Hodge James G, Links Jonathan M
Johns Hopkins Center for Public Health Preparedness, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Room E7035, Baltimore, MD 21208, USA.
Public Health Rep. 2009 Mar-Apr;124(2):295-303. doi: 10.1177/003335490912400218.
In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies.
The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process.
The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice.
The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.
面对全灾种防范挑战，地方和州卫生部门人员迄今缺乏一套明确的、基于法律和伦理的公共卫生原则，以指导在危机情况下分配稀缺资源。为了填补这一空白，我们召集了一次学术和实践专家峰会，以制定一套在紧急情况下进行合法且符合伦理的公共卫生资源分诊决策的原则。
2006年6月29日在华盛顿特区举行的仅限受邀者参加的峰会，汇聚了来自学术机构以及非学术领导、政策和实践领域的20位专家。峰会开展了一次桌面演练，旨在突出公共卫生传染病紧急情况中的资源稀缺挑战。这次演练成为峰会参与者随后通过反复过程确定10项公共卫生应急资源分配原则的跳板。
峰会的最终成果是一套10项原则，用于指导公共卫生紧急情况下涉及稀缺资源的分配决策。这些原则分为三类：对社区的义务；平衡个人自主权与社区福祉/利益；以及良好的防范实践。
峰会得出的这10项原则代表了将法律、伦理与现实世界的公共卫生应急资源分配实践相联系的一次尝试，可作为一个有用的起始框架，以指导在全灾种背景下应对公共卫生资源稀缺问题的进一步系统方法和未来研究。
