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《避免孤独离世:新冠疫情期间需使医院探视政策民主化》

Not Dying Alone: the Need to Democratize Hospital Visitation Policies During Covid-19.

机构信息

Faculty of Law and Faculty of Humanities, Women and Gender Studies, University of Haifa, Haifa, Israel.

出版信息

Med Law Rev. 2021 Dec 6;29(4):613-638. doi: 10.1093/medlaw/fwab033.

Abstract

Of the many adverse outcomes that may result from the spread of the severe acute respiratory syndrome coronavirus 2, known as COVID-19, one stands out as particularly vile: the experience of dying alone. Many healthcare facilities in the US and elsewhere adopted 'No-Visitor Rules' in an effort to contain the virus, but these rules mean that the countless people in nursing homes and hospital wards were isolated during their final hours of life. There is no epidemiological or US federal or state requirement to prohibit visitation to (and thereby isolate) dying patients-even those with COVID-19. Instead, constructing pandemic-specific visitation policies is usually left to the discretion of hospitals and healthcare providers. Such policies aim to limit the risk of exposure but fail to account for the individual and social costs associated with dying alone for patients, families, and frontline healthcare workers. As a result, the policies may be overly restrictive and actively cause harm. This article argues that US hospital visitation policies need to be democratised to include the perspectives of community members and patients. By drawing on existing patient rights frameworks, this article outlines several legal strategies to reconceptualise hospital visitation policies as a civil rights issue.

摘要

在由严重急性呼吸系统综合症冠状病毒 2 (即 COVID-19)传播所带来的众多不良后果中,有一个后果尤为恶劣:独自死亡的经历。为了遏制病毒,美国和其他地方的许多医疗机构都采取了“禁止访客”的规定,但这些规定意味着在养老院和病房中的无数人在生命的最后时刻被隔离。没有任何流行病学或美国联邦或州的要求禁止(从而隔离)临终患者,即使是那些患有 COVID-19 的患者。相反,构建针对大流行的特定探视政策通常由医院和医疗保健提供者自行决定。这些政策旨在限制暴露的风险,但没有考虑到患者、家属和一线医疗保健工作者独自死亡所带来的个人和社会成本。因此,这些政策可能过于严格,实际上会造成伤害。本文认为,美国医院探视政策需要民主化,纳入社区成员和患者的观点。本文通过借鉴现有的患者权利框架,概述了几种法律策略,将医院探视政策重新概念化为公民权利问题。

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