Assistant Professor of Pediatrics in the Department of Pediatrics, Division of Hematology/Oncology, the Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee USA.
Associate Professor of Pediatrics in the Division of Pediatric Critical Care Medicine at Seattle Children's Hospital, University of Washington School of Medicine, and Treuman Katz Center for Pediatric Bioethics in Seattle, Washington USA.
J Clin Ethics. 2021 Spring;32(1):20-34.
With each novel infectious disease outbreak, there is scholarly attention to healthcare providers' obligation to assume personal risk while they care for infected patients. While most agree that healthcare providers have a duty to assume some degree of risk, the extent of this obligation remains uncertain. Furthermore, these analyses rarely examine healthcare institutions' obligations during these outbreaks. As a result, there is little practical guidance for healthcare institutions that are forced to weigh whether or when to exclude healthcare providers from providing care or allow them to opt out from providing care to protect themselves. This article uses the COVID-19 pandemic to examine the concept of risk and the professional duties of both healthcare providers and healthcare institutions, and proposes a framework that can be used to make concrete institutional policy choices. This framework should be a useful tool for any hospital, clinic, or health agency that must make these choices during the current pandemic and beyond.
随着每一次新发传染病的爆发，学术界都关注医疗保健提供者在照顾感染患者时承担个人风险的义务。虽然大多数人都认为医疗保健提供者有一定程度的义务承担风险，但这种义务的程度仍然不确定。此外，这些分析很少涉及医疗机构在这些疫情爆发期间的义务。因此，对于那些被迫权衡是否以及何时将医疗保健提供者排除在护理之外，或者允许他们选择不提供护理以保护自己的医疗机构来说，几乎没有实际的指导。本文利用 COVID-19 大流行来检验风险概念以及医疗保健提供者和医疗机构的职业责任，并提出一个框架，可以用来做出具体的机构政策选择。这个框架对于任何在当前大流行期间和之后都必须做出这些选择的医院、诊所或卫生机构来说，应该是一个有用的工具。
