Smith Maxwell J, Upshur Ross E G
University of Toronto.
Public Health Ethics. 2015 Nov;8(3):305-318. doi: 10.1093/phe/phv028. Epub 2015 Oct 17.
The exercise of identifying lessons in the aftermath of a major public health emergency is of immense importance for the improvement of global public health emergency preparedness and response. Despite the persistence of the Ebola Virus Disease (EVD) outbreak in West Africa, it seems that the Ebola 'lessons learned' exercise is now in full swing. On our assessment, a significant shortcoming plagues recent articulations of lessons learned, particularly among those emerging from organizational reflections. In this article we argue that, despite not being recognized as such, the vast majority of lessons proffered in this literature should be understood as lessons stemming from failures, and that any improvements in future global public health emergency preparedness and response are in large part dependent on acknowledging this fact and adjusting priorities, policies and practices accordingly such that they align with values that better ensure these moral failures are not repeated and that new moral failures do not arise. We cannot continue to fiddle at the margins without critically reflecting on our repeated moral failings and committing ourselves to a set of values that engenders an approach to global public health emergencies that embodies a sense of solidarity and global justice.
在重大突发公共卫生事件发生后总结经验教训,对于提升全球突发公共卫生事件的防范与应对能力至关重要。尽管西非埃博拉病毒病(EVD)疫情持续蔓延,但埃博拉“经验教训”总结工作似乎正在全面展开。据我们评估,近期总结的经验教训存在一个重大缺陷,尤其是在那些源于组织反思的经验教训中。在本文中,我们认为,尽管未被明确承认,但该文献中提出的绝大多数经验教训应被理解为源于失败的教训,而且未来全球突发公共卫生事件防范与应对能力的任何提升,在很大程度上都取决于承认这一事实,并据此调整优先事项、政策和做法,使其与能更好确保不再重蹈这些道德失败覆辙且不产生新的道德失败的价值观保持一致。我们不能再在细枝末节上做文章,而不认真反思我们反复出现的道德失败,并致力于一套能催生一种体现团结和全球正义意识的全球突发公共卫生事件应对方法的价值观。