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接触埃博拉受害者:强制、劝说还是呼吁自我牺牲?

Reaching out to Ebola victims: Coercion, persuasion or an appeal for self-sacrifice?

作者信息

Calain Philippe, Poncin Marc

机构信息

Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, 1211 Genève 21, Switzerland.

Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, 1211 Genève 21, Switzerland.

出版信息

Soc Sci Med. 2015 Dec;147:126-33. doi: 10.1016/j.socscimed.2015.10.063. Epub 2015 Nov 9.

Abstract

The 2014-2015 Ebola crisis in West Africa has highlighted the practical limits of upholding human rights and common ethical principles when applying emergency public-health measures. The role of medical teams in the implementation of quarantine and isolation has been equivocal, particularly when such measures are opposed by communities who are coerced by the temporary suspension of civil liberties. In their encounters with Ebola victims, outreach teams face moral dilemmas, where the boundaries are unclear between coercion, persuasion and appeals for self-sacrifice. For those teams, we propose a set of practical recommendations aimed at respecting the autonomy of epidemic victims and easing tensions within communities. We recognize that some of these recommendations are progressively achievable, depending on the specific stage or setting of an outbreak. Yet with the increasing availability of experimental treatments and research interventions, weighing patients' autonomy against the common good will become an even more pressing ethical obligation.

摘要

2014 - 2015年西非埃博拉危机凸显了在采取紧急公共卫生措施时维护人权和共同伦理原则的实际局限性。医疗队在实施隔离检疫措施中的作用一直模糊不清,尤其是当这些措施遭到社区反对时,因为社区会因公民自由的暂时中止而受到胁迫。在与埃博拉受害者接触时,外展团队面临道德困境,在强制、劝说和呼吁自我牺牲之间界限并不明确。针对这些团队,我们提出了一系列切实可行的建议,旨在尊重疫情受害者的自主权并缓解社区内的紧张关系。我们认识到,其中一些建议可根据疫情爆发的具体阶段或情况逐步实现。然而,随着实验性治疗和研究干预手段越来越多,权衡患者自主权与公共利益将成为一项更为紧迫的伦理义务。

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