Department of Medical Education, The College of Medicine, King Saud University, Riyadh, Saudi Arabia
Department of Medical Education, The College of Medicine, King Saud University, Riyadh, Saudi Arabia.
J Med Ethics. 2023 Apr;49(4):275-282. doi: 10.1136/jme-2022-108369. Epub 2022 Dec 8.
Given the wide-reaching and detrimental impact of COVID-19, its strain on healthcare resources, and the urgent need for-sometimes forced-public health interventions, thorough examination of the ethical issues brought to light by the pandemic is especially warranted. This paper aims to identify some of the complex moral dilemmas faced by senior physicians at a major medical centre in Saudi Arabia, in an effort to gain a better understanding of how they navigated ethical uncertainty during a time of crisis. This qualitative study uses a semistructured interview approach and reports the findings of 16 interviews. The study finds that participants were motivated by a profession-based moral obligation to provide care during the toughest and most uncertain times of the pandemic. Although participants described significant moral dilemmas during their practice, very few identified challenges as ethical in nature, and in turn, none sought formal ethics support. Rather, participants took on the burden of resolving ethical challenges themselves-whenever possible-rationalising oft fraught decisions by likening their experiences to wartime action or by minimising attention to the moral. In capturing these accounts, this paper ultimately contemplates what moral lessons can, and must be, learnt from this experience.
鉴于 COVID-19 的广泛影响和危害性，其对医疗资源的压力，以及对公共卫生干预措施的迫切需求——有时甚至是强制要求，彻底审查大流行所带来的伦理问题是特别有必要的。本文旨在确定沙特阿拉伯一家主要医疗中心的资深医生所面临的一些复杂道德困境，努力更好地了解他们如何在危机时期应对伦理不确定性。这项定性研究使用半结构化访谈方法，报告了 16 次访谈的结果。研究发现，参与者的动机是基于职业的道德义务，即在大流行最艰难和最不确定的时期提供护理。尽管参与者在实践中描述了重大的道德困境，但很少有人将挑战视为具有本质上的伦理性质，因此，也没有人寻求正式的伦理支持。相反，参与者自己承担了解决伦理挑战的负担——只要有可能——通过将自己的经验比作战时行动，或者通过最小化对道德的关注，来合理化经常充满矛盾的决策。通过记录这些叙述，本文最终思考了可以从这一经验中吸取哪些道德教训，以及必须吸取哪些道德教训。
