Fritz Zoë, Huppert Julian L, Liddell Kathleen, Holton Richard, Fuld Jonathan P
The Healthcare Improvement Studies (THIS) Institute, Cambridge, UK and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Jesus College, Cambridge; visiting professor in the Policy Institute, King's College London.
Clin Med (Lond). 2021 Mar;21(2):e122-e125. doi: 10.7861/clinmed.2020-0843. Epub 2020 Dec 29.
There is an urgent need for an ethical framework to help us address the local and national challenges that we face as clinicians during the COVID-19 pandemic. We propose four key commitments from which a practical and consistent ethical approach can be derived. These commitments are to articulate the needs, rights and interests of the different stakeholders affected by any policy; to be accountable and transparent, recognising that people are autonomous individuals with values and concerns of their own; to consider the impact of our actions on the sustainability of the NHS, infrastructure, service demands and staff welfare; and to treat everybody equitably, with all deserving of consideration and care. Implementing these commitments will require a number of specific actions. We must put in place frameworks enabling clear advocacy for each competing objective; communicate policy and practice effectively to the public; promote integration of decision-making among social, primary, secondary and tertiary care and reduce or stop unnecessary or inefficient interventions; minimise health inequalities; and build spare capacity into the system.In this article, we expand on these actions, and note the legal context in which this would be delivered.
迫切需要一个道德框架来帮助我们应对在新冠疫情期间作为临床医生所面临的地方和国家层面的挑战。我们提出四项关键承诺，从中可以得出切实可行且一致的道德方法。这些承诺包括：阐明受任何政策影响的不同利益相关者的需求、权利和利益；做到问责和透明，认识到人们是有自身价值观和关切的自主个体；考虑我们的行动对国民医疗服务体系（NHS）的可持续性、基础设施、服务需求和员工福利的影响；公平对待每一个人，所有人都应得到考虑和关怀。落实这些承诺将需要采取一些具体行动。我们必须建立框架，以便为每个相互竞争的目标进行明确的倡导；有效地向公众传达政策和做法；促进社会、初级、二级和三级护理之间决策的整合，减少或停止不必要或低效的干预措施；尽量减少健康不平等现象；并在系统中建立备用能力。在本文中，我们详细阐述这些行动，并指出实施这些行动的法律背景。
