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[重症监护病房中的情绪:护理人员的情感与道德责任]

[Moods in critical care units: emotions and moral duties of care providers].

作者信息

Fourel D, Segondi A, Delaunay M, Gallego C

机构信息

BCRM de Brest, service de réanimation, hôpital d'Instruction des armées Clermont-Tonnerre, CC-41, 29240 Brest cedex 9, France.

BCRM de Brest, service de psychiatrie, hôpital d'Instruction des armées Clermont-Tonnerre, CC-41, 29240 Brest cedex 9, France.

出版信息

Ethique Sante. 2021 Dec;18(4):217-223. doi: 10.1016/j.etiqe.2021.08.002. Epub 2021 Aug 27.

Abstract

The Covid-19 pandemic instills emotions that can be understood in the pathological sense of mental disorder and/or in the heuristic sense of a moral dimension. So what about this distinction in critical care and resuscitation services where caregivers are at the forefront of events? What to do with emotions? The objective of this work is to pose a medico-psychological and ethical perspective on these questions, starting from the hypothesis that emotions have a specific use during the pandemic. The first step will be to show that anguish and fear, although different from an epistemological point of view, arise from the same historical place, which is the discourse of the medical world with death. The awareness of the inevitable makes share the same need of the caregiver and the citizen of a psychic economy which will lead to differentiating two possible reactions to emotions: one to face up and one to come to terms with. This psychic interlacing, inherent to the pandemic context, calls for critical care on a moral dimension related to the issue of abandonment of the human person and the poorly understood notion of "mass death". An answer to this difficulty would be found in the concept of "being-caregiver-close" but its application also supposes an ethical reflection on the outlets and the personal virtues.

摘要

新冠疫情引发的情绪,既可以从精神障碍的病理学意义上理解,也可以从道德维度的启发意义上理解。那么,在重症监护和复苏服务中,护理人员处于事件前沿,这种区别又如何呢?如何应对这些情绪?本文的目的是从情绪在疫情期间具有特定用途这一假设出发,就这些问题提出医学心理学和伦理学的观点。第一步将是表明,痛苦和恐惧虽然从认识论角度来看有所不同,但都源于同一个历史根源,即医学界关于死亡的论述。对不可避免之事的认识,使得护理人员和公民都有同样的心理经济需求,这将导致对情绪有两种可能的反应:一种是直面,一种是接受。这种疫情背景下固有的心理交织,需要在与抛弃人类以及理解不深的“大规模死亡”概念相关的道德层面进行重症护理。在“贴近护理者”的概念中可以找到解决这一难题的答案,但其应用也需要对出路和个人美德进行伦理思考。

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