Shah Aarati, Aacharya Ramesh Prasad
Medical Education Commission, Sanothimi, Bhaktapur, Nepal.
JNMA J Nepal Med Assoc. 2020 Apr 30;58(224):276-279. doi: 10.31729/jnma.4959.
Pandemic outbreak of COVID-19 is the largest of its kind of this century. All countries throughout the globe are trying their best to contain the disease and eliminate at the earliest. Efforts are continuing to improve the outcome of the infection in terms of minimizing the morbidity and mortality. As a public health strategy every state has the responsibility of protecting the health of the community and such measures includes the preventive measures like social distancing or even lockdown of the state as a whole restricting the movement of the people, diagnostic measures like testing the suspects, contact tracing and isolation of the patients. Treatment of the infected requires decisions in resource constraint situation particularly ICU beds and ventilators. In the meantime, protecting doctors, nurses, other health workers as well as frontline workers need personal protective equipment which is a scarce commodity. While doing so there might be a compromise in the individual autonomy, privacy, confidentiality, and social justice for the beneficence for the larger community. This is an attempt to explore the ethical quandaries in relation to combating COVID-19 in Nepal by relating the issues with the principles of biomedical ethics.
新型冠状病毒肺炎(COVID-19)大流行是本世纪规模最大的此类疫情。全球所有国家都在尽最大努力控制疫情并尽早消除疫情。各方持续努力改善感染结果,以尽量降低发病率和死亡率。作为一项公共卫生战略,每个国家都有责任保护社区健康,此类措施包括社会 distancing 等预防措施,甚至是对整个国家实施封锁以限制人员流动,对疑似病例进行检测、追踪接触者以及隔离患者等诊断措施。对感染者的治疗需要在资源有限的情况下做出决策,尤其是重症监护病房床位和呼吸机方面。与此同时,保护医生、护士、其他医护人员以及一线工作者需要个人防护装备,而这是一种稀缺物资。在这样做的过程中,为了更大社区的利益,可能会在个人自主权、隐私、保密和社会正义方面做出妥协。本文旨在通过将这些问题与生物医学伦理原则相关联,探讨尼泊尔在抗击 COVID-19 方面的伦理困境。