Institute of Global Health and Human Ecology, School of Science and Engineering, The American University in Cairo, Cairo, Egypt.
Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Front Public Health. 2021 Aug 2;9:649918. doi: 10.3389/fpubh.2021.649918. eCollection 2021.
During pandemics, the ethicists, public health professionals, and human rights advocates raise a red flag about different public health actions that should, at best, be addressed through integrated, global policies. How to rationalize the healthcare resources and prioritize the cases is not a recent challenge but the serious concern about that is how to achieve this while not increasing the vulnerability of the disadvantaged population. Healthcare professionals use different scoring systems as a part of their decision-making so the medical teams and triage committees can allocate resources for predictable health outcomes and prognosis as well as to appropriately triage the patients accordingly. However, the value of the existing scoring systems to manage COVID-19 cases is not well-established yet. Part of this problem includes managing non-COVID patients with chronic medical conditions like non-communicable diseases and addressing their medical needs during the pandemic complex context in a way to avoid worsening their conditions and, on the other hand, avoid hindering the establishment of comprehensive standards for dealing with COVID-19. In this article, we discuss this dilemma as well as how preexisting ethical standards were challenged by COVID-19. We also discuss how monitoring the consistent application of ethical standards during the medical trials of new medications, vaccines, or unproven medical interventions is also a critical issue.
在大流行期间,伦理学家、公共卫生专业人员和人权倡导者对各种公共卫生措施提出了警告,这些措施最好通过综合的全球政策来解决。如何合理配置医疗资源和优先考虑病例,这并不是一个新的挑战,但更令人关注的是如何在不增加弱势群体脆弱性的情况下实现这一目标。医疗保健专业人员使用不同的评分系统作为其决策的一部分,以便医疗团队和分诊委员会能够根据可预测的健康结果和预后分配资源,并相应地对患者进行适当分诊。然而,现有的评分系统在管理 COVID-19 病例方面的价值尚未得到充分确立。造成这一问题的部分原因是在大流行的复杂背景下,管理患有非传染性疾病等慢性疾病的非 COVID 患者,并以避免病情恶化的方式满足他们的医疗需求,另一方面,避免阻碍建立全面的 COVID-19 处理标准。本文讨论了这一两难困境,以及 COVID-19 如何挑战现有的伦理标准。我们还讨论了如何在新药物、疫苗或未经证实的医疗干预措施的临床试验中监测伦理标准的一致应用,这也是一个关键问题。