Hastings Cent Rep. 2020 May;50(3):54-56. doi: 10.1002/hast.1133.
The Covid-19 pandemic has concentrated bioethics attention on the "lifeboat ethics" of rationing and fair allocation of scarce medical resources, such as testing, intensive care unit beds, and ventilators. This focus drives ethics resources away from persistent and systemic problems-in particular, the structural injustices that give rise to health disparities affecting disadvantaged communities of color. Bioethics, long allied with academic medicine and highly attentive to individual decision-making, has largely neglected its responsibility to address these difficult "upstream" issues. It is time to broaden our teaching, research, and practice to match the breadth of the field in order to help address these significant societal inequities and unmet health needs.
Covid-19 大流行使人们关注于医疗资源分配的“救生艇伦理”,如测试、重症监护病房床位和呼吸机的分配。这种关注使伦理资源远离持续存在的系统性问题,特别是导致影响有色人种弱势群体健康差距的结构性不公正。长期以来,生物伦理学与学术医学结盟,并高度关注个人决策,但在很大程度上忽视了其解决这些困难的“上游”问题的责任。现在是拓宽我们的教学、研究和实践的时候了,以匹配该领域的广度,从而帮助解决这些重大的社会不平等和未满足的健康需求。