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在 COVID-19 大流行期间,州际个人防护设备库存管理决策和伙伴关系中的伦理原则。

Ethical Principles in Personal Protective Equipment Inventory Management Decisions and Partnerships Across State Lines During the COVID-19 Pandemic.

机构信息

Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Rosalind Franklin University of Medicine and Science Chicago Medical School, Chicago, IL, USA.

出版信息

Public Health Rep. 2022 Mar-Apr;137(2):208-212. doi: 10.1177/00333549211058734. Epub 2021 Dec 30.

Abstract

The COVID-19 pandemic created unprecedented strain on the personal protective equipment (PPE) supply chain. Given the dearth of PPE and consequences for transmission, GetMePPE Chicago (GMPC) developed a PPE allocation framework and system, distributing 886 900 units to 274 institutions from March 2020 to July 2021 to address PPE needs. As the pandemic evolved, GMPC made difficult decisions about (1) building reserve inventory (to balance present and future, potentially higher clinical acuity, needs), (2) donating to other states/out-of-state organizations, and (3) receiving donations from other states. In this case study, we detail both GMPC's experience in making these decisions and the ethical frameworks that guided these decisions. We also reflect on lessons learned and suggest which values may have been in conflict (eg, maximizing benefits vs duty to mission, defined in the context of PPE allocation) in each circumstance, which values were prioritized, and when that prioritization would change. Such guidance can promote a values-based approach to key issues concerning distribution of PPE and other scarce medical resources in response to the COVID-19 pandemic and related future pandemics.

摘要

新冠疫情大流行给个人防护装备 (PPE) 供应链带来了前所未有的压力。考虑到 PPE 的短缺及其传播的后果,芝加哥获取个人防护装备组织 (GMPC) 开发了一个 PPE 分配框架和系统,从 2020 年 3 月到 2021 年 7 月,向 274 个机构分发了 886900 件个人防护装备,以满足 PPE 的需求。随着疫情的发展,GMPC 不得不艰难地做出关于以下方面的决策:(1) 建立储备库存 (以平衡当前和未来、潜在更高的临床严重性的需求);(2) 向其他州/州外组织捐赠;(3) 接受其他州的捐赠。在这个案例研究中,我们详细介绍了 GMPC 在做出这些决策时的经验以及指导这些决策的伦理框架。我们还反思了从中吸取的教训,并提出了在每种情况下可能存在冲突的价值观 (例如,最大化利益与使命责任,在 PPE 分配的背景下定义)、被优先考虑的价值观以及何时会改变优先级。这种指导可以促进一种基于价值观的方法,用于解决与新冠疫情和相关未来大流行期间 PPE 及其他稀缺医疗资源分配有关的关键问题。

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