Associate Professor of Medicine, Director Humanities Track and History of Medicine Series, Sidney Kimmel Medical College of Thomas Jefferson University, Hamilton Building, 1001 Locust Street, Suite 309c, Philadelphia, PA 19107, USA.
Professor, Department of Family, Population & Preventive Medicine, Division Head, Medicine in Society, Director, Center for Medical Humanities, Compassionate Care & Bioethics, Stony Brook University School of Medicine, Health Sciences Tower, Level 3, Rm 080B, Stony Brook, New York 11794-8335, USA.
Am J Med Sci. 2021 Feb;361(2):146-150. doi: 10.1016/j.amjms.2020.11.018. Epub 2020 Nov 23.
The Covid-19 pandemic struck physicians at a time of unprecedented dissatisfaction and burnout, providing a stress test whose lessons might guide structural changes in healthcare. While selflessly rescuing patients from death, many doctors were exposed to unacceptable risk, with little protection for themselves, and, by extension, for their families and patients. This essay examines the basis and limits of duty to treat in a time of crisis and explores how these experiences could leave doctors morally stressed and even compromised. We question whether a physician-patient relationship that treats patients' safety and well-being as separate from their doctors' personal and professional values, needs, and dignity is the best way to deliver care. Such questions predated coronavirus but were brought to the forefront because of the epidemic. As physicians process their experiences, we hope to begin a deeper moral and social conversation that might help us be better prepared for future crises.
新冠疫情大流行之际，医生们正处于前所未有的不满和倦怠之中，这是一场压力测试，其经验教训可能为医疗保健的结构性变革提供指导。许多医生在不顾个人安危抢救病人的同时，几乎没有为自己、家人和病人提供任何保护，这令人无法接受。本文探讨了危机时刻治疗义务的基础和局限性，并探讨了这些经历如何使医生在道德上感到压力甚至受到损害。我们质疑将患者的安全和健康与医生的个人和职业价值观、需求和尊严分开对待的医患关系是否是提供护理的最佳方式。这些问题在冠状病毒之前就已经存在，但由于疫情而被提上了日程。随着医生们对自己的经历进行处理，我们希望能够开始一场更深入的道德和社会对话，这或许有助于我们为未来的危机做好更充分的准备。
