Smith Erin, Burkle Frederick M, Gebbie Kristine, Ford David, Bensimon Cécile
1Edith Cowan University,School of Medical and Health Sciences,Joondalup,WesternAustralia.
3Harvard Humanitarian Initiative,Harvard University and Harvard T.C. Chan School of Public Health,Cambridge,MassachusettsUSA.
Prehosp Disaster Med. 2018 Oct;33(5):466-470. doi: 10.1017/S1049023X18000857. Epub 2018 Oct 9.
IntroductionThe Australian prehospital profession has not yet facilitated a comprehensive discussion regarding paramedic role and responsibility during disasters. Whether paramedics have a duty to treat under extreme conditions and what acceptable limitations may be placed on such a duty require urgent consideration. The purpose of this research is to encourage discussion within the paramedic profession and broader community on this important ethical and legal issue.
The authors employed qualitative methods to gather paramedic and community member perspectives in Victoria, Australia.
These findings suggested that both paramedic and community member participants agree that acceptable limitations on paramedic duty to treat during disaster are required. These limitations should be based on consideration of the following factors: personal health circumstances (eg, pregnancy for female paramedics); pre-existing mental health conditions (eg, posttraumatic stress disorder/PTSD); competing personal obligations (eg, paramedics who are single parents); and unacceptable levels of personal risk (eg, risk of exposure and infection during a pandemic).
It is only with the engagement of a more broadly representative segment of the prehospital profession and greater Australian community that appropriate guidance on limiting standards of care under extreme conditions can be developed and integrated within prehospital care in Australia. SmithE, BurkleFM Jr., GebbieK, FordD, BensimonC. Acceptable limitations on paramedic duty to treat during disaster: a qualitative exploration. Prehosp Disaster Med. 2018;33(5):466-470.
引言
澳大利亚院前急救行业尚未就灾难期间护理人员的角色和职责展开全面讨论。护理人员在极端条件下是否有治疗的义务以及对此义务可设置哪些可接受的限制，这需要紧急考虑。本研究的目的是鼓励护理人员行业及更广泛的社区就这一重要的伦理和法律问题展开讨论。
作者采用定性方法收集了澳大利亚维多利亚州护理人员和社区成员的观点。
这些研究结果表明，护理人员和社区成员参与者都认为，灾难期间护理人员的治疗义务需要有可接受的限制。这些限制应基于对以下因素的考虑：个人健康状况（例如，女护理人员怀孕）；既往心理健康状况（例如，创伤后应激障碍/PTSD）；相互冲突的个人义务（例如，单亲护理人员）；以及不可接受的个人风险水平（例如，大流行期间接触和感染的风险）。
只有让院前急救行业更具广泛代表性的群体以及更广大的澳大利亚社区参与进来，才能制定出关于在极端条件下限制护理标准的适当指导意见，并将其纳入澳大利亚的院前急救护理中。史密斯E、伯克尔FM Jr.、吉比K、福特D、本西蒙C。灾难期间护理人员治疗义务的可接受限制：一项定性探索。院前灾难医学。2018；33(5):466 - 470。
