Khaji Ali, Larijani Bagher, Ghodsi Seyed Mohammad, Mohagheghi Mohammad A, Khankeh Hammid R, Saadat Soheil, Tabatabaei Seyed Mahmoud, Khorasani-Zavareh Davoud
Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Arch Bone Jt Surg. 2018 Jul;6(4):269-276.
Industrialization could bring risk of Technological Disaster (TD) such as happened in Chernobyl, Bhopal and Fukushima crisis. Little has been discussed about its related ethical issues. In this study, we aimed to investigate ethical issues have been stated for technological disasters.
A systematic search was conducted on the main international literature databases including Pubmed, Embase, Scopus and ISI (Jan 1, 2000 to Jan 1, 2018). From 64articles were eligible for investigation of ethical issues in Natural disaster, 6 was related to Technological Disaster. The articles were in English language.
Our result show that there are seven articles discussing ethical issues during Technological disaster. All of them are related to nuclear crisis in Fukushima resulting from Japan tsunami 2011. These articles discussed mainly three ethical issues in providing medical care to victims of Technological Disasters as follow: 1- Duty of care 2- Mandatory evacuationand3- Resource Allocation.
Victim health is the main factor for making decision and implementation of any programs during response to disasters. Mandatory Evacuation for reasons other than providing health to people (such as: maintain public order) and if bring health risk to people will be unjustified. Duty of health workers for providing care is based on General beneficence meanwhile it is necessary to provide facilities to protect them from dangers that treat them in the field. For act ethically, Health workers must have adequate preparedness for response to T-D meanwhile it is necessary to provide guidelines for individuals that participation in relief operation. It is necessary to discuss more about Technological Disaster Ethics especially in industrial countries and where there is especial industrial with potential of huge crises.
工业化可能带来技术灾难（TD）风险，如切尔诺贝利、博帕尔和福岛危机。关于其相关伦理问题的讨论较少。在本研究中，我们旨在调查已阐述的技术灾难伦理问题。
对包括Pubmed、Embase、Scopus和ISI在内的主要国际文献数据库进行系统检索（2000年1月1日至2018年1月1日）。在64篇符合自然灾害伦理问题调查的文章中，有6篇与技术灾难相关。这些文章均为英文。
我们的结果显示，有7篇文章讨论了技术灾难期间的伦理问题。所有这些文章都与2011年日本海啸引发的福岛核危机有关。这些文章主要讨论了在为技术灾难受害者提供医疗护理时的三个伦理问题，如下：1. 护理责任；2. 强制疏散；3. 资源分配。
受害者健康是应对灾难期间做出任何决策和实施任何项目的主要因素。出于为民众提供健康以外的原因（如维持公共秩序）进行强制疏散，且如果给民众带来健康风险，将是不合理的。医护人员提供护理的责任基于一般的行善原则，同时有必要提供设施以保护他们在现场救治时免受危险。为了合乎道德地行事，医护人员必须为应对技术灾难做好充分准备，同时有必要为参与救援行动的个人提供指导方针。有必要更多地讨论技术灾难伦理，特别是在工业化国家以及存在潜在巨大危机的特殊行业所在地区。
