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孟加拉国 COVID-19 期间医护人员的道德困境和患者的不信任。

Moral distress among healthcare providers and mistrust among patients during COVID-19 in Bangladesh.

出版信息

Dev World Bioeth. 2021 Dec;21(4):187-192. doi: 10.1111/dewb.12291. Epub 2020 Sep 18.

DOI:10.1111/dewb.12291
PMID:32949075
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7537122/
Abstract

The COVID-19 pandemic has shaken the world through its first wave, and we have yet to experience the second wave. Even resourceful countries have failed to adequately prevent epidemics in their country, and for countries like Bangladesh, which already has strained an ineffective healthcare system, the challenges to contain the SARS-CoV-2 virus are that much more severe. Due to the scarcity of resources and systematic failures the Bangladeshi people deeply mistrust the healthcare system. The mistrust is further magnified as healthcare providers are hesitant to treat the patients because of the lack of proper protective gear. Physicians have a moral obligation to serve and treat patients; however, they have a moral obligation to protect their families. This dilemma places healthcare providers in situations where they experience moral distress. This article specifically discusses the importance of interpersonal relationships in driving change, using the framework of Responsiveness, while stating the need for complementary systematic change in order to rebuild trust in the Bangladeshi healthcare system.

摘要

新冠疫情席卷全球,我们尚未迎来第二波疫情。即使是资源丰富的国家,也未能成功在本国预防疫情,而孟加拉国的医疗体系本就捉襟见肘,应对新冠病毒的挑战更是难上加难。由于资源匮乏和系统性失灵,孟加拉国民众对医疗体系严重缺乏信任。由于医护人员缺乏适当的防护设备,不愿治疗患者,这种不信任感进一步加剧。医生有服务和治疗患者的道德义务;然而,他们也有保护家人的道德义务。这种困境使医护人员陷入道德困境。本文专门讨论了人际关系在推动变革方面的重要性,使用了响应性框架,并指出需要进行互补的系统性变革,以重建孟加拉国医疗体系的信任。