Valera Luca, Carrasco María Alejandra, López Rodrigo, Ramos Paulina, von Bernhardi Rommy, Bedregal Paula, Florenzano Alejandra, Pérez Iván, Olivares Patricia, Vargas Ivonne, González Ximena, López Paulo, Durán Gloria, Richards Constanza, Castro Ricardo
Centro de Bioética, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2020 Mar;148(3):393-398. doi: 10.4067/S0034-98872020000300393.
The catastrophic emergency experienced by many countries with the COVID-19 pandemic emphasized the importance of bioethics for decision-making, both at the public health (equitable and effective policies) and at the clinical level. At the clinical level, the issues are the fulfillment of medical care demand with adequate health care teams, infrastructure, and supplies, and to cover critical care demands that surpass the available resources. Therefore, ethically correct approaches are required for the allocation of life sustaining resources. There are recommendations for the allocating life support during disasters based on multiple considerations, including ethical ones. However, the ethical criteria of existing guidelines are variable. Ethical principles usually considered are saving the greatest number of lives, saving the greatest number of years of life and the principle of the life cycle or the goal to give each individual equal opportunity to live through the various phases of life. However, the centrality of the human being and the search for the common good should be considered. Knowledge of public perspectives and moral benchmarks on these issues is essential. A successful assignment effort will require everyone's trust and cooperation. Decision making should be planned and discussed in advance, since in-depth deliberation will be extremely complex during the disaster. Our goal is to help the health care teams to wisely allocate resources in shortage periods.
许多国家在新冠疫情期间经历的灾难性紧急情况凸显了生物伦理学在公共卫生(公平有效的政策)和临床层面决策中的重要性。在临床层面,问题在于配备足够的医疗团队、基础设施和物资以满足医疗需求,并应对超出可用资源的重症护理需求。因此,在分配维持生命的资源时需要符合伦理的正确方法。基于包括伦理因素在内的多重考量,有关于在灾难期间分配生命支持的建议。然而,现有指南的伦理标准各不相同。通常考虑的伦理原则包括拯救最多的生命、拯救最多的生命年数以及生命周期原则或让每个人都有平等机会度过生命各个阶段的目标。然而,应考虑人的核心地位和对共同利益的追求。了解公众对这些问题的看法和道德基准至关重要。成功的分配工作需要每个人的信任与合作。决策应提前规划和讨论,因为在灾难期间进行深入审议将极其复杂。我们的目标是帮助医疗团队在资源短缺时期明智地分配资源。