Hastings Cent Rep. 2020 May;50(3):10-11. doi: 10.1002/hast.1109. Epub 2020 May 5.
As I organize a pile of ethics consult chart notes in New York City in mid-April 2020, I look at the ten cases that I have co-consulted on recently. Nine of the patients were found to be Covid positive. The reasons for the consults are mostly familiar-surrogate decision-making, informed refusal of treatment, goals of care, defining futility. But the context is unfamiliar and unsettling. Bioethicists are in pandemic mode, dusting off and revising triage plans. Patients and potential patients are fearful-of the disease itself and of the amplification of health disparities and inequities. There is much to contemplate, but as I go through my cases, I worry about disability, about biases and racist stereotypes. In this pandemic, historically marginalized communities are at risk of further disenfranchisement.
2020 年 4 月中旬，我在纽约整理一堆伦理咨询图表记录，查看最近共同咨询的十个案例。其中九个患者的新冠病毒检测呈阳性。咨询的原因大多是熟悉的——代理决策、知情拒绝治疗、治疗目标、确定无效。但背景却令人陌生和不安。生物伦理学家进入大流行模式，重新修订分类计划。患者和潜在患者都感到恐惧——对疾病本身以及健康差距和不平等的扩大感到恐惧。有很多需要思考，但当我处理我的案例时，我担心残疾，担心偏见和种族主义刻板印象。在这场大流行中，历史上处于边缘地位的社区面临着进一步被剥夺权利的风险。
