Aquino Yves S J, Cabrera Nicolo
Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA.
J Med Ethics. 2020 Sep;46(9):574-578. doi: 10.1136/medethics-2020-106306. Epub 2020 Jul 9.
The controversy surrounding the use of hydroxychloroquine (HCQ), an antimalarial drug, for COVID-19 has raised numerous ethical and policy problems. Since the suggestion that HCQ has potential for COVID-19, there have been varying responses from clinicians and healthcare institutions, ranging from adoption of protocols using HCQ for routine care to the conduct of randomised controlled trials to an effective system-wide prohibition on its use for COVID-19. In this article, we argue that the concept of 'disease public profile' has become a prominent, if not the sole, determinant in decision-making across various healthcare responses to the pandemic. In the case of COVID-19, the disease's public profile is based on clinical and non-clinical factors that include contagiousness, clinical presentation and media coverage. In particular, we briefly examine the dangers of a heightened public profile in magnifying the inequality of diseases and undermining three key ethical concepts, namely (1) evidence-based practice, (2) sustainable allocation and (3) meaningful consent.
围绕抗疟药物羟氯喹（HCQ）用于治疗新冠肺炎所引发的争议，带来了诸多伦理和政策问题。自从有人提出HCQ对新冠肺炎可能有效以来，临床医生和医疗机构就出现了不同反应，从采用使用HCQ的方案进行常规治疗，到开展随机对照试验，再到在全系统有效禁止将其用于新冠肺炎治疗。在本文中，我们认为，“疾病公众形象”这一概念已成为在针对该疫情的各种医疗应对决策中一个突出（即便不是唯一）的决定因素。就新冠肺炎而言，该疾病的公众形象基于包括传染性、临床表现和媒体报道在内的临床和非临床因素。我们特别简要探讨了过高的公众形象在加剧疾病不平等以及损害三个关键伦理概念方面的危险性，这三个概念分别是：（1）循证实践，（2）可持续分配，以及（3）有意义的同意。
