Sydney Health Ethics, Sydney School of Public Health, University of Sydney, Building 1, Level 1, Medical Foundations Building, 92/94 Parramatta Rd, Camperdown, NSW, 2050, Australia.
Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, Australia.
Can J Public Health. 2020 Aug;111(4):459-461. doi: 10.17269/s41997-020-00354-x. Epub 2020 Jul 8.
Social distancing is an important and necessary measure to help arrest the spread of SARS-CoV-2 during the COVID-19 pandemic. However, it does place persons who are socially or politically marginalized, including those who are of lower socio-economic status, at risk of further harms. In other words, marginalized or disadvantaged persons are at risk of both contracting SARS-CoV-2 and the risk of harms that may come about because of the social distancing measures themselves. Finally, a third layer of risk faced by marginalized persons would be the overuse of utility (i.e., maximize the benefit of resource x) as the primary ethics principle upon which to make allocation decisions, since oftentimes it is resource-intensive to help those in positions of social marginality. This three-fold risk of harm to which marginalized persons are subjected runs counter to the very notion of social justice that underpins public health. Social distancing in a socially just manner requires dialoguing with affected populations and providing social supports to marginalized persons, regardless of the associated costs.
社交隔离是帮助控制 COVID-19 大流行期间 SARS-CoV-2 传播的重要且必要的措施。然而，它确实会使社会或政治上处于边缘地位的人面临更大的伤害风险，包括那些社会经济地位较低的人。换句话说，边缘化或处于不利地位的人不仅有感染 SARS-CoV-2 的风险，而且还有可能因社交隔离措施本身而面临伤害的风险。最后，边缘化者面临的第三层风险是过度使用功利主义（即最大化资源 x 的效益）作为做出分配决策的主要伦理原则，因为帮助那些处于社会边缘地位的人通常需要大量的资源。边缘化者所面临的这种三重伤害风险与公共卫生所依据的社会正义观念背道而驰。以一种公正的方式进行社交隔离需要与受影响的人群进行对话，并为边缘化者提供社会支持，而不论相关成本如何。
