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[临床经验与关键问题。]

[Clinical experience and critical issues.].

作者信息

Nacoti Mirco

机构信息

Terapia Intensiva Pediatrica, Dipartimento di Anestesia e Rianimazione, ASST Papa Giovanni XXIII, Bergamo.

出版信息

Recenti Prog Med. 2020 Jun;111(6):374-378. doi: 10.1701/3394.33760.

Abstract

Bergamo is a rich and populous city of northern Italy and one of the epicentres of the worldwide pandemic CoViD-19. Despite the generosity of health workers, we are undergoing a severe humanitarian crisis that is stressing every aspect of daily life. From outside it is very hard to understand, because houses are closed for lockdown and are not destroyed as they would be in an earthquake. An outbreak is not "only" a sudden mass lethal incident, like a natural disaster, neither "only" a disease, to be treated by doctors, but a social phenomenon too. Historical and social elements are key factors for development (for example, intensive promiscuity between animals and humans) and spread of an epidemic (for example, health workers and ambulance rapidly become vector of the virus). Can medical responsibility change in times of pandemic? My answer, as anaesthetist and intensive care physician from Bergamo, is yes. When the global medical community is called on to face a pandemic of unprecedented scale, with little scientific evidence and "crazy numbers" describing the situation, honest and forthcoming advocacy is an ethical duty. Aim of this narrative report is to share a view point about the dilemma of moral responsibility.

摘要

贝加莫是意大利北部一个富裕且人口众多的城市,也是全球新冠疫情的中心之一。尽管医护人员慷慨付出,但我们仍在经历一场严重的人道主义危机,这场危机正给日常生活的方方面面带来压力。从外部很难理解,因为房屋因封锁而关闭,不像在地震中那样被摧毁。疫情爆发“不仅仅”是像自然灾害那样突然发生的大规模致命事件,也“不仅仅”是一种疾病,由医生进行治疗,它还是一种社会现象。历史和社会因素是疫情发展(例如,动物与人类之间的频繁接触)和传播(例如,医护人员和救护车迅速成为病毒的传播媒介)的关键因素。在疫情期间医疗责任会发生变化吗?作为一名来自贝加莫的麻醉师和重症监护医生,我的回答是肯定的。当全球医学界被要求面对一场规模空前的疫情,且几乎没有科学证据,只有“惊人数字”来描述这种情况时,诚实且坦率的倡导是一项道德义务。本叙述性报告的目的是分享关于道德责任困境的一种观点。

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