Robert René, Kentish-Barnes Nancy, Boyer Alexandre, Laurent Alexandra, Azoulay Elie, Reignier Jean
Université de Poitiers, Poitiers, France.
Inserm CIC 1402, Axe Alive, Poitiers, France.
Ann Intensive Care. 2020 Jun 17;10(1):84. doi: 10.1186/s13613-020-00702-7.
The devastating pandemic that has stricken the worldwide population induced an unprecedented influx of patients in ICUs, raising ethical concerns not only surrounding triage and withdrawal of life support decisions, but also regarding family visits and quality of end-of-life support. These ingredients are liable to shake up our ethical principles, sharpen our ethical dilemmas, and lead to situations of major caregiver sufferings. Proposals have been made to rationalize triage policies in conjunction with ethical justifications. However, whatever the angle of approach, imbalance between utilitarian and individual ethics leads to unsolvable discomforts that caregivers will need to overcome. With this in mind, we aimed to point out some critical ethical choices with which ICU caregivers have been confronted during the Covid-19 pandemic and to underline their limits. The formalized strategies integrating the relevant tools of ethical reflection were disseminated without deviating from usual practices, leaving to intensivists the ultimate choice of decision.
这场席卷全球人口的毁灭性大流行病导致重症监护病房（ICU）前所未有的患者涌入，引发了一系列伦理问题，不仅涉及分诊和生命支持决策的撤销，还包括家属探视和临终支持质量。这些因素可能动摇我们的伦理原则，加剧我们的伦理困境，并导致主要护理人员承受巨大痛苦。有人提出结合伦理依据使分诊政策合理化。然而，无论从何种角度来看，功利主义伦理与个体伦理之间的失衡都会导致无法解决的困扰，护理人员需要克服这些困扰。考虑到这一点，我们旨在指出新冠疫情期间ICU护理人员面临的一些关键伦理选择，并强调其局限性。整合了相关伦理思考工具的正式策略在不偏离常规做法的情况下得以传播，将最终的决策选择权留给了重症监护医生。
