Paediatric Bioethics Centre, University College London Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre, London,WC1N 1EH, UK
Paediatric Bioethics Centre, University College London Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre, London,WC1N 1EH, UK.
Postgrad Med J. 2021 Feb;97(1144):119-122. doi: 10.1136/postgradmedj-2020-137991. Epub 2020 Oct 17.
The Birkenhead drill states that in the time of crisis, the correct action is to prioritise the weakest and most vulnerable, in that example, women and children. Ethically this has been well analysed in terms of the intrinsic value of the human versus any utilitarian calculus of worth to society's function. We do not attempt to re-analyse this but do note that standard pandemic planning often disadvantages the weak and vulnerable in terms of allocation of resources to those with a greater chance of functional survival. We more argue from a debt that society owes its children in terms of the sacrifices they have made in terms of school, social life, healthcare and overall welfare during the pandemic from which they were at markedly less risk than adults. Society owes a debt to its young, and this on top of pre-existing commitments to the them that most nations fail to realise, calls for prioritisation of children and young people's issues as society rebuilds. The effects of poverty and systemic racism on many children must be tackled; so too the existential threats of climate change and pollution. COVID-19 provides a once in a generation opportunity to create a kinder, fairer society. Early signs are not good: Pub re-opening prioritised over school re-opening; no significant investment in children's services or women's health, a significant determinant of children's welfare. We highlight the way COVID-19 has, and continues, to harm children and argue that the contemporary erosion of the Birkenhead principle is simply amoral.
伯肯黑德演习指出,在危机时刻,正确的行动是优先考虑最弱势和最脆弱的群体,在该示例中是妇女和儿童。从人类内在价值与社会功能的功利主义计算价值的角度来看,这在伦理上已经得到了很好的分析。我们不会重新分析这一点,但请注意,标准的大流行病规划通常在资源分配方面对弱势和脆弱群体不利,因为他们更有可能实现功能生存。我们更多地从社会在大流行期间对儿童所做的牺牲中所欠儿童的债务角度出发,从学校、社交生活、医疗保健和整体福利方面,他们的风险明显低于成年人。社会欠年轻人一笔债,除了大多数国家未能实现的预先存在的对他们的承诺之外,这要求在社会重建过程中优先考虑儿童和年轻人的问题。必须解决许多儿童面临的贫困和系统性种族主义的影响;同样,也必须解决气候变化和污染的生存威胁。COVID-19 提供了一个千载难逢的机会,可以创建一个更友善、更公平的社会。早期迹象并不乐观:酒吧重新开放优先于学校重新开放;对儿童服务或妇女健康的投资不足,而这是儿童福利的重要决定因素。我们强调 COVID-19 已经并继续对儿童造成伤害,并认为当代伯肯黑德原则的侵蚀是不道德的。