Bibler Trevor M, Nelson Ryan H, Schuman Olivia, Miller Susan M
Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston TX.
Houston Methodist Hospital, Houston, TX.
Crit Care Explor. 2021 Dec 2;3(12):e0581. doi: 10.1097/CCE.0000000000000581. eCollection 2021 Dec.
Critical care professionals in the United States are experiencing distress and frustration during the recent delta-wave of the coronavirus disease 2019 pandemic. This wave feels different because most, although not all, patients suffering with the sequelae from coronavirus disease 2019 who enter ICUs are unvaccinated. Since vaccines in the United States are safe, effective, and widely available for people 12 and older, severe cases of coronavirus disease 2019 are now considered preventable. However, even when a disease is preventable, critical care professionals still have remaining role-based, ethical obligations to their patients. Developing additional mechanisms for reflection and resilience, in spite of accumulated frustrations from otherwise preventable mortality, may help the professional and those they care for. In this essay, we propose a number of questions that recognize the existential frustrations critical care professionals experience, while also uncovering the ethical obligations that remain. Rather than becoming comfortable with silence or frustration, these reflections intend to bridge the gap between feeling frustrated and building relationships that benefit both the patient and the critical care professional during this pandemic.
在美国，重症监护专业人员在2019冠状病毒病疫情最近的德尔塔浪潮期间正经历着困扰和挫折。这一波疫情感觉有所不同，因为大多数（尽管不是全部）进入重症监护病房的2019冠状病毒病后遗症患者都未接种疫苗。由于美国的疫苗对12岁及以上人群来说安全、有效且广泛可用，现在认为2019冠状病毒病的重症病例是可以预防的。然而，即使一种疾病是可以预防的，重症监护专业人员对其患者仍负有基于角色的道德义务。尽管因原本可预防的死亡而积累了挫折感，但开发更多反思和恢复力的机制可能会对专业人员及其护理对象有所帮助。在本文中，我们提出了一些问题，这些问题既认识到重症监护专业人员所经历的生存挫折，同时也揭示了仍然存在的道德义务。这些反思并非要对沉默或挫折感到习以为常，而是旨在弥合在此次疫情期间感到沮丧与建立对患者和重症监护专业人员都有益的关系之间的差距。
