a Duke University Medical Center.
Am J Bioeth. 2015;15(4):26-32. doi: 10.1080/15265161.2015.1010995.
The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. However, there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care--resources in scarce supply in the area--I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the resources available to successfully manage them is effective palliative care. However, this could hasten death in this vulnerable population and hence, while ethically and medically justifiable, is not without social risk.
目前西非的埃博拉病毒疫情似乎正在失控。最坏的预测表明，如果不加控制，到 2015 年 1 月底，疫情可能导致近 140 万例病例，病死率至少为 50%。美国和欧洲国家已开始认真应对，承诺提供物资、隔离床位和训练有素的医疗人员，以遏制疫情和照顾病人。然而，目前既没有针对埃博拉感染的疫苗，也没有特定的治疗方法，治疗的理想方法是集中在支持性护理上。我曾认为，在一场压倒性的健康灾难中，特别是在大流行性流感期间，提供姑息治疗是强制性的。由于受感染的埃博拉患者在技术先进的重症监护下（该地区资源稀缺）效果最好，我建议，对于大量病情严重、濒临死亡和痛苦的埃博拉患者，如果他们的病情严重到足以压垮现有的资源，唯一可以接受的方法是有效的姑息治疗。然而，这可能会加速这一脆弱人群的死亡，因此，虽然在伦理和医学上是合理的，但并非没有社会风险。
