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Refutation of the Charges of Cowardice Made against Galen.对加伦怯懦指控的驳斥
Ann Med Hist. 1931 Mar;3(2):195-208.
2
A virus-like particle vaccine candidate for influenza A virus based on multiple conserved antigens presented on hepatitis B tandem core particles.基于乙型肝炎串联核心颗粒上呈现的多种保守抗原的甲型流感病毒样颗粒疫苗候选物。
Vaccine. 2018 Feb 1;36(6):873-880. doi: 10.1016/j.vaccine.2017.12.053. Epub 2018 Jan 3.
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The role of risk perception in willingness to respond to the 2014-2016 West African Ebola outbreak: a qualitative study of international health care workers.风险认知在应对2014 - 2016年西非埃博拉疫情意愿中的作用:一项针对国际医护人员的定性研究
Glob Health Res Policy. 2017 Aug 7;2:21. doi: 10.1186/s41256-017-0042-y. eCollection 2017.
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The Neglected Dimension of Global Security--A Framework for Countering Infectious-Disease Crises.全球安全被忽视的层面——应对传染病危机的框架
N Engl J Med. 2016 Mar 31;374(13):1281-7. doi: 10.1056/NEJMsr1600236. Epub 2016 Jan 13.
5
Willingness of the local health department workforce to respond to infectious disease events: empirical, ethical, and legal considerations.当地卫生部门工作人员应对传染病事件的意愿:实证、伦理和法律考量
Biosecur Bioterror. 2014 Jul-Aug;12(4):178-85. doi: 10.1089/bsp.2014.0009. Epub 2014 Jun 25.
6
Factors associated with the willingness of health care personnel to work during an influenza public health emergency: an integrative review.与卫生保健人员在流感公共卫生事件期间工作意愿相关的因素:综合评价。
Prehosp Disaster Med. 2012 Dec;27(6):551-66. doi: 10.1017/S1049023X12001331. Epub 2012 Oct 2.
7
Willingness to respond in a disaster: a pediatric nurse practitioner national survey.灾难应对意愿:儿科护士从业者全国调查。
J Pediatr Health Care. 2012 Jul-Aug;26(4):e7-20. doi: 10.1016/j.pedhc.2010.11.003. Epub 2011 Feb 21.
8
Factors associated with the ability and willingness of essential workers to report to duty during a pandemic.与基本工作人员在大流行期间报告工作的能力和意愿相关的因素。
J Occup Environ Med. 2010 Oct;52(10):995-1003. doi: 10.1097/JOM.0b013e3181f43872.
9
Mitigating absenteeism in hospital workers during a pandemic.减轻大流行期间医院工作人员的旷工现象。
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10
Will the NHS continue to function in an influenza pandemic? A survey of healthcare workers in the West Midlands, UK.英国国民医疗服务体系(NHS)在流感大流行期间还能继续运转吗?对英国西米德兰兹郡医护人员的一项调查。
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如果我的健康受到威胁,我必须做出回应吗?

Must I Respond if My Health is at Risk?

作者信息

Iserson Kenneth V

机构信息

International Federation for Emergency Medicine and Department of Emergency Medicine, The University of Arizona, Tucson, Arizona.

出版信息

J Emerg Med. 2018 Aug;55(2):288-293. doi: 10.1016/j.jemermed.2018.04.021.

DOI:10.1016/j.jemermed.2018.04.021
PMID:29773480
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7134772/
Abstract

BACKGROUND

Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested.

DISCUSSION

It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community. Despite numerous medical ethical codes, nothing-either morally or legally-requires a response to risk-prone situations from civilian clinicians; it remains a personal decision. The most important questions are: What will encourage us to respond to these situations? And will we respond? These questions are necessary, not only for physicians and other direct health care providers, but also for vital health care system support personnel. Those who provide care in the face of perceived risk demonstrate heroic bravery, but the choice to do so has varied throughout history. To improve individual response rates, disaster planners and managers must communicate the risks clearly to all members of the health care system and help mitigate their risks by providing them with as much support and security as possible.

CONCLUSIONS

The decision to remain in or to leave a risky health care situation will ultimately depend on the provider's own risk assessment and value system. If history is any guide, we can rest assured that most clinicians will choose to stay, following the heroic example established through the centuries and continuing today.

摘要

背景

大规模流行病、大流行及其他易引发风险的灾难频繁发生,其规律令人不安。此类事件发生时,临床医生应如何应对,又会作何反应?医疗专业人员的道德支柱——将患者需求置于首位的职责——可能会受到严峻考验。

讨论

医疗保健专业人员有责任思考,如果危险的医疗保健情况同时威胁到自身和所在社区,我们必须做什么以及应该做什么。尽管有众多医学伦理准则,但在道德或法律层面,并无要求平民临床医生应对易引发风险的情况;这仍是个人决定。最重要的问题是:什么会促使我们应对这些情况?我们会做出回应吗?这些问题不仅对医生和其他直接的医疗保健提供者至关重要,对至关重要的医疗保健系统支持人员也同样重要。那些在面临可感知风险时仍提供护理的人展现出了英勇无畏,但这样做的选择在历史上却不尽相同。为提高个人的反应率,灾难规划者和管理者必须向医疗保健系统的所有成员清晰传达风险,并通过尽可能为他们提供支持和保障来帮助减轻他们的风险。

结论

决定留在还是离开危险的医疗保健环境最终将取决于提供者自身的风险评估和价值体系。如果以历史为鉴,我们可以放心,大多数临床医生会选择留下来,追随几个世纪以来树立并延续至今的英勇典范。