National Coordination Centre for Communicable Disease Control, RIVM-Centre for Communicable Diseases, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.
Monash Bioeth Rev. 2020 Dec;38(Suppl 1):47-55. doi: 10.1007/s40592-020-00119-9. Epub 2020 Nov 7.
Control measures directed at carriers of multidrug-resistant organisms are traditionally approached as a trade-off between public interests on the one hand and individual autonomy on the other. We propose to reframe the ethical issue and consider control measures directed at carriers an issue of solidarity. Rather than asking "whether it is justified to impose strict measures", we propose asking "how to best care for a person's carriership and well-being in ways that do not imply an unacceptable risk for others?". A solidarity approach could include elevating baseline levels of precaution measures and accepting certain risks in cases where there is exceptionally much at stake. A generous national compensation policy that also covers for costs related to dedicated care is essential in a solidarity approach. An additional benefit of reframing the questions is that it helps to better acknowledge that being subjected to control measures is a highly personal matter.
传统上，针对多药耐药菌携带者的控制措施被视为在公共利益和个人自主权之间进行权衡。我们建议重新构建伦理问题，并将针对携带者的控制措施视为团结问题。我们不是要问“是否有理由实施严格的措施”，而是要问“如何以最好的方式照顾携带者的健康和福祉，同时又不会给他人带来不可接受的风险？”。团结的方法可以包括提高预防措施的基本水平，并在存在特殊风险的情况下接受某些风险。在团结的方法中，一个慷慨的国家赔偿政策，也包括专门护理相关的费用，是至关重要的。重新构建问题的另一个好处是，它有助于更好地认识到接受控制措施是一个高度个人化的问题。
