Hastings Cent Rep. 2020 May;50(3):33-35. doi: 10.1002/hast.1129.
The Covid-19 pandemic has sparked rapid and voluminous production of bioethics commentary in popular media and academic publications. Many of the discussions are new twists on an old theme: how to fairly allocate scarce medical resources, such as ventilators and intensive care unit beds. In this essay, we do not add another allocation scheme to the growing pile, partly out of appreciation that such schemes should be products of inclusive and transparent community engagement and partly out of recognition of their limited utility for physicians working in the field. Instead, we make the more modest claim that context matters when making such decisions and, more specifically, that recommendations from high-income countries about fair allocation during Covid-19 should not be cut and pasted into low-income settings. We offer a few examples of why seemingly universal, well-intentioned ethical recommendations could have adverse consequences if unreflectively applied in sub-Saharan Africa.
Covid-19 大流行促使大众媒体和学术出版物上迅速大量地产生了生物伦理学评论。许多讨论都是老调重弹：如何公平分配稀缺的医疗资源，如呼吸机和重症监护病房床位。在本文中，我们没有再提出另一种分配方案，部分原因是我们赞赏此类方案应该是包容性和透明的社区参与的产物，部分原因是我们认识到它们对于在该领域工作的医生的实用性有限。相反，我们提出了一个更适度的主张，即在做出此类决策时，背景很重要，更具体地说，高收入国家在 Covid-19 期间提出的公平分配建议不应该不加思考地应用于低收入环境中。我们提供了一些例子来说明，如果在撒哈拉以南非洲地区不加思考地应用看似普遍的、善意的道德建议，可能会产生不良后果。
