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纳入利益相关者对稀缺资源配置的观点:从危机时期的政策制定中吸取的教训。

Incorporating Stakeholder Perspectives on Scarce Resource Allocation: Lessons Learned from Policymaking in a Time of Crisis.

出版信息

Camb Q Healthc Ethics. 2021 Apr;30(2):390-402. doi: 10.1017/S0963180120000924.

Abstract

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work.

摘要

新型冠状病毒病(COVID-19)危机引发了组织伦理困境:如何在坚持提供以关系和患者为中心的护理的组织使命的同时制定合乎伦理的大流行政策。 我们的机构中的生物伦理部门和调查与访谈方法学家承担了制定有关医疗保健工作者和基本人员是否应在大流行期间优先获得有限医疗资源的建议的任务,他们在政策制定过程中采用了一种深思熟虑的方法,纳入了医疗专业人员和患者利益相关者的观点。在危机期间,更多地参与社区,而不是更少地参与社区,需要平衡迅速采取行动以收集利益相关者观点的需求、对大流行的程度和持续时间的不确定性,以及伦理学家之间对分配稀缺资源的最合乎伦理支持方式的分歧。本文解释了为征求利益相关者意见而进行的过程,这些意见与组织伦理有关,回顾了所分享的利益相关者观点以及它们如何为制定的分类政策提供信息,并就其他组织如何将利益相关者参与纳入道德决策以及未来的研究和公共卫生工作提供了建议。

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