Daniel Michelle
Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
J Clin Ethics. 2012 Winter;23(4):331-5.
During disasters, clinicians may be forced to play dual roles, as both a provider and an allocator of scarce resources. At present, a clear framework to govern resource stewardship at the bedside is lacking. Clinicians who find themselves practicing in this ethical gap between clinical and public health ethics can experience significant moral distress. One provider describes her experience allocating an oxygen tank in the intensive care unit at a hospital in Port-au-Prince, Haiti, immediately following the 2010 earthquake. Using a clinical vignette and reflective narrative she attempts to identify the factors that influenced her allocation decision, opening up the factors for commentary and debate by an ethicist. A better paradigm for the ethical care of patients during disasters is needed to better guide provider choices in the future.
在灾难期间，临床医生可能被迫扮演双重角色，既是稀缺资源的提供者，又是分配者。目前，缺乏一个明确的框架来管理床边资源的管理。发现自己在临床伦理和公共卫生伦理之间的这种道德差距中执业的临床医生可能会经历严重的道德困扰。一位提供者描述了她在2010年海地太子港地震后立即在一家医院的重症监护病房分配氧气瓶的经历。她通过一个临床案例和反思性叙述，试图找出影响她分配决定的因素，并引发一位伦理学家对这些因素的评论和辩论。需要一个更好的灾难期间患者伦理护理范式，以便在未来更好地指导提供者的选择。
