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历史重演:两种大流行病的伦理准则。

[History repeats itself: an ethic for two pandemics.].

作者信息

Cruz-Piqueras Maite, Cruz-Piqueras Maite

机构信息

Escuela Andaluza de Salud Pública. Granada. España.

Red ESPACyOS (Ética Salubrista Para la Acción, Cuidados y Observación Social).

出版信息

Rev Esp Salud Publica. 2022 Oct 5;96:e202210063.

Abstract

The emergence of the human immunodeficiency virus (HIV) in the 1980s brought ethical conflicts that meant a bioethics challenge. Among others, issues of confidentiality, stigmatization, justice, duty of care and investigation arose. Bioethical reflection had been focused on conflicts involving respect for individual autonomy, nevertheless HIV highlighted the needs of the community. Almost four decades later, the COVID-19 pandemic has brought the ethical conflicts typical of public health back to the bioethical scene. Quarantines, various restrictions on mobility, the obligation of masks, poorly protected health care, rationing of scarce resources, rushed research, the vaccines allocation, stigmatization and discrimination, the immune passport, or the moralization of infectious disease have highlighted the need for an ethical framework that helps to reflect and justify public health decisions. In this article we review and analyze the ethical conflicts that arose with HIV and how they have reappeared and been reinterpreted with the COVID-19 pandemic.

摘要

20世纪80年代人类免疫缺陷病毒(HIV)的出现带来了伦理冲突,这意味着一项生物伦理挑战。其中出现了保密、污名化、正义、护理责任和调查等问题。生物伦理反思一直聚焦于涉及尊重个人自主权的冲突,然而HIV凸显了社区的需求。近四十年后,新冠疫情将公共卫生领域典型的伦理冲突重新带回了生物伦理舞台。隔离、各种行动限制、口罩义务、防护不佳的医疗保健、稀缺资源的配给、仓促的研究、疫苗分配、污名化和歧视、免疫护照,或者传染病的道德化,都凸显了建立一个有助于反思和证明公共卫生决策合理性的伦理框架的必要性。在本文中,我们回顾并分析了与HIV相关的伦理冲突,以及它们如何在新冠疫情中再次出现并被重新诠释。

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