Newman Louise, O'Connor Beth, Reynolds Vernon, Newhouse George
University of Melbourne, Australia.
Former Medicines Sans Frontiers' (MSF), Nauru.
Australas Psychiatry. 2020 Oct;28(5):585-588. doi: 10.1177/1039856220956251. Epub 2020 Sep 10.
Between 2013 and 2019, an estimated 200 children seeking asylum in Australia were detained on the island of Nauru. In 2018, 15 of these children developed the rare and life-threatening pervasive refusal syndrome (PRS). This paper describes the PRS case cluster, the complexities faced by clinicians managing these cases, and the lessons that can be learned from this outbreak.
The emergence of PRS on Nauru highlighted the risks of long-term detention of children in settings that are unable to meet their physical and psycho-social needs. The case cluster also underscored (a) the difficulties faced by doctors working in conditions where their medical and legal obligations may be in direct conflict, and (b) the role of clinicians in patient advocacy.
2013年至2019年期间，估计有200名在澳大利亚寻求庇护的儿童被拘留在瑙鲁岛。2018年，其中15名儿童患上了罕见且危及生命的广泛性拒绝综合征（PRS）。本文描述了PRS病例群、管理这些病例的临床医生所面临的复杂性，以及可从此疫情中吸取的教训。
瑙鲁出现的PRS凸显了在无法满足儿童身体和心理社会需求的环境中长期拘留儿童的风险。该病例群还强调了（a）在医疗和法律义务可能直接冲突的条件下工作的医生所面临的困难，以及（b）临床医生在患者维权方面的作用。
