Chervenak Frank A, Moreno Jonathan D, Grünebaum Amos
Department of Obstetrics and Gynecology, Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Department of Obstetrics and Gynecology, Lenox Hill Hospital, New York, NY, USA.
J Perinat Med. 2022 Mar 16;50(5):528-532. doi: 10.1515/jpm-2022-0055. Print 2022 Jun 27.
The scientific evidence about COVID-19 and pregnancy is conclusive: COVID-19 infections increase the risk of stillbirths and preterm births, and pregnant and postpartum patients are more likely to get severely ill with COVID-19 and die when compared with people who are not pregnant. Getting a COVID-19 vaccine protects from severe illness from COVID-19 and risk of death. COVID-19 vaccination is recommended for pregnant patients, those trying to conceive, and who are breastfeeding, or might become pregnant in the future. The justification for government involvement in public health measures that restrict personal liberty that we are so familiar with today emanated from a philosophical source at the same time as the progress in managing infectious disease. John Stuart Mill (1806-1873), an empiricist and a utilitarian, was not specifically addressing the ethics of public health in his classic On Liberty (1859), but his arguments have become the reference point for liberal democracies and public health measures. Mill was in search of a philosophical principle that could justify constraints on personal freedom. John Stuart Mill gives direct guidance to our approach supporting not only strong recommendations for pregnant patients to accept vaccinations against COVID-19 but also for those working in healthcare setting to be required to be vaccinated. This approach is respectful to our patient's liberty while doing all that's reasonable to protect them from harm. Based on our professional experience we recognize that some physicians and patients have fixed false beliefs. Physicians espousing fixed false beliefs against COVID-19 vaccines should be censured.
新冠病毒感染会增加死产和早产风险，与未怀孕的人相比，孕妇和产后患者感染新冠病毒后患重病和死亡的可能性更大。接种新冠病毒疫苗可预防新冠病毒感染导致的重病和死亡风险。建议为孕妇、正在备孕的人、哺乳期妇女或未来可能怀孕的人接种新冠病毒疫苗。政府参与我们如今所熟知的限制个人自由的公共卫生措施，其正当性与传染病管理的进步同时源于一种哲学思想。经验主义者兼功利主义者约翰·斯图尔特·密尔（1806 - 1873）在其经典著作《论自由》（1859年）中并未专门论述公共卫生伦理，但他的观点已成为自由民主国家和公共卫生措施的参考依据。密尔在探寻一种能够证明对个人自由进行限制具有正当性的哲学原则。约翰·斯图尔特·密尔为我们的做法提供了直接指导，不仅支持强烈建议孕妇接种新冠病毒疫苗，也支持要求医疗保健机构工作人员接种疫苗。这种做法在尽合理努力保护患者免受伤害的同时，尊重了患者的自由。基于我们的专业经验，我们认识到一些医生和患者持有顽固的错误观念。坚持反对新冠病毒疫苗的顽固错误观念的医生应受到谴责。
