Faculty of Social Sciences, University of Kuopio, Kuopio, Finland.
Acta Anaesthesiol Scand. 2010 Jan;54(1):9-15. doi: 10.1111/j.1399-6576.2009.02163.x. Epub 2009 Nov 16.
The 2009 influenza A/H1N1 pandemic seems to be only moderately severe. In the future, a pandemic influenza with high lethality, such as the Spanish influenza in 1918-1919 or even worse, may emerge. In this kind of scenario, lethality rates ranging roughly from 2% to 30% have been proposed. Legal and ethical issues should be discussed before the incident. This article aims to highlight the legal, ethical and professional aspects that might be relevant to anaesthesiologists in the case of a high-lethality infectious disease such as a severe pandemic influenza. The epidemiology, the role of anaesthesiologists and possible threats to the profession and colleagueship within medical specialties relevant to anaesthesiologists are reviewed. During historical plague epidemics, some doctors have behaved like 'deserters'. However, during the Spanish influenza, physicians remained at their jobs, although many perished. In surveys, more than half of the health-care workers have reported their willingness to work in the case of severe pandemics. Physicians have the same human rights as all citizens: they have to be effectively protected against infectious disease. However, they have a duty to treat. Fair and responsible colleagueship among the diverse medical specialties should be promoted. Until disaster threatens humanity, volunteering to work during a pandemic might be the best way to ensure that physicians and other health-care workers stay at their workplace. Broad discussion in society is needed.
2009 年甲型 H1N1 流感大流行似乎只是中度严重。未来，可能会出现一种致死率较高的大流行性流感，如 1918-1919 年的西班牙流感，甚至更糟。在这种情况下，提出的致死率范围约为 2%至 30%。在事件发生之前，应该讨论法律和伦理问题。本文旨在强调在严重大流行性流感等高致死性传染病的情况下，与麻醉师相关的法律、伦理和专业方面的问题。本文回顾了流行病学、麻醉师的作用以及与麻醉师相关的医学专业内部对专业和同事关系可能产生的威胁。在历史上的瘟疫流行期间，一些医生的行为就像“逃兵”。然而，在西班牙流感期间，医生们坚守岗位，尽管许多人因此丧生。在调查中，超过一半的医护人员表示愿意在发生严重大流行时工作。医生与所有公民一样享有相同的人权：他们必须得到有效保护，免受传染病的侵害。然而，他们也有责任进行治疗。应该促进不同医学专业之间公平和负责任的同事关系。在灾难威胁到人类之前，自愿在大流行期间工作可能是确保医生和其他医护人员留在工作岗位的最佳方式。需要在社会上进行广泛的讨论。
