Aacharya Ramesh P, Tiwari Sanjeeb, Shrestha Tirtha M
Department of Emergency and General Practice, Tribhuvan University Teaching Hospital Institute of Medicine, Kathmandu, Nepal,.
Indian J Med Ethics. 2017 Jan-Mar;2(1):25-29. doi: 10.20529/IJME.2017.005. Epub 2016 Oct 19.
The Nepal earthquake was one of the biggest natural calamities of the year 2015. This paper attempts to explore the ethical issues involved in the humanitarian services rendered during the crisis and thereafter. The four principles of biomedical ethics - autonomy, beneficence, non-maleficence, and justice - are discussed in relation to the relief activities immediately following the disaster and the subsequent long-term activities, such as rehabilitation, wherever applicable. The discussion touches upon public health components such as vulnerable populations, environmental ethics and justice for the future. Incorporating ethical principles into the response to disasters is of vital importance to ensure that healthcare complies with professional norms and ethical standards, and is in tune with the medical needs of the local culture. Beneficence is prioritised, while non-maleficence and autonomy tend to be ignored. Justice, particularly distributive justice, deserves due attention in the context of limited resources, not only during the emergency phase but also during the phases of rehabilitation and planning for the future.
尼泊尔地震是2015年最大的自然灾害之一。本文试图探讨危机期间及之后提供人道主义服务所涉及的伦理问题。生物医学伦理的四项原则——自主、行善、不伤害和公正——结合灾难后的救援活动以及随后的长期活动（如适用时的康复活动）进行了讨论。讨论涉及公共卫生组成部分，如弱势群体、环境伦理和对未来的公正。将伦理原则纳入灾害应对至关重要，以确保医疗保健符合专业规范和伦理标准，并与当地文化的医疗需求相协调。行善被优先考虑，而不伤害和自主往往被忽视。在资源有限的情况下，公正，尤其是分配公正，不仅在紧急阶段，而且在康复和未来规划阶段都应得到应有的关注。
