Microbiology Department, Barts and the London NHS Trust, London, UK.
J Hosp Infect. 2009 Nov;73(3):232-8. doi: 10.1016/j.jhin.2009.07.024. Epub 2009 Sep 26.
Strategies for the control of the spread of infection in hospitals may lead to constraints on individual autonomy, freedom of movement, or contact with others. Codes of (ethical) practice for healthcare professionals tend to emphasise responsibilities to individual patients. Ethical frameworks for public health focus on groups of individuals (populations), the majority of whom are relatively healthy and empowered. Hospital infection control professionals must take account of both of these perspectives, sensitive to the care of infected and potentially infectious individuals, while protecting the vulnerable and relatively dependent population of hospital patients from further compromise to their health. A number of frameworks for an ethics of public health have been proposed over the last few years but there are sufficient differences in ethical considerations between collective interventions that aim to protect and promote the health of the public and interventions taken in the context of hospital infection control to justify a distinctive ethics of hospital infection control. Professional bodies may be best placed to lead the development of such a framework.
医院感染控制策略可能会限制个人的自主权、行动自由或与他人的接触。医疗保健专业人员的(道德)行为准则往往强调对个别患者的责任。公共卫生的伦理框架侧重于个人群体(人群),其中大多数人相对健康且有能力。医院感染控制专业人员必须同时考虑这两个方面,既要关心受感染和可能具有传染性的个人,又要保护医院病人这一弱势群体和相对依赖人群,避免他们的健康进一步受损。过去几年已经提出了一些公共卫生伦理学框架,但旨在保护和促进公众健康的集体干预措施与医院感染控制背景下采取的干预措施之间存在足够的伦理考虑差异,有理由制定独特的医院感染控制伦理学。专业机构可能最适合领导这一框架的制定。