Maya Sabatello and Paul S. Appelbaum are with the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Teresa Blankmeyer Burke is with the Department of History, Philosophy, Religion, and Sociology, Gallaudet University, Washington, DC. Katherine E. McDonald is with the Department of Public Health, Falk College, Syracuse University, Syracuse, NY.
Am J Public Health. 2020 Oct;110(10):1523-1527. doi: 10.2105/AJPH.2020.305837. Epub 2020 Aug 20.
This article considers key ethical, legal, and medical dilemmas arising for people with disabilities in the COVID-19 pandemic. We highlight the limited application of existing frameworks of emergency planning with and for people with disabilities in the COVID-19 pandemic, explore key concerns and issues affecting the health care of people with disabilities (i.e., access to information and clinician-patient communication, nondiscrimination and reasonable accommodations, and rationing of medical goods), and indicate possible solutions. Finally, we suggest clinical and public health policy measures to ensure that people with disabilities are included in the planning of future pandemic-related efforts.The devastation evoked by the COVID-19 pandemic raises challenging dilemmas in bioethics. It also speaks to social justice issues that have plagued historically marginalized communities in the United States.Responses to the pandemic must be bound by legal standards, principles of distributive justice, and societal norms of protecting vulnerable populations-core commitments of public health-to ensure that inequities are not exacerbated, and should provide a pathway for improvements to ensure equitable access and treatment in the future.
本文探讨了在 COVID-19 大流行期间残疾人所面临的关键伦理、法律和医疗困境。我们强调了在 COVID-19 大流行期间,现有的残疾人应急规划框架的应用有限,探讨了影响残疾人医疗保健的关键问题和关切(即获取信息和医患沟通、非歧视和平等对待以及医疗用品的配给),并指出了可能的解决方案。最后,我们提出了临床和公共卫生政策措施,以确保在未来与大流行相关的努力中纳入残疾人。COVID-19 大流行所引发的灾难带来了严峻的生物伦理学困境。它也反映了美国历史上边缘化社区一直存在的社会正义问题。对大流行的应对必须受到法律标准、分配正义原则和保护弱势群体的社会规范的约束——这是公共卫生的核心承诺——以确保不平等现象不会加剧,并为未来确保公平获取和治疗提供途径。