Dees Richard H, Herington Jonathan, Chiafery Marianne, Shand Jessica C, D'Angio Carl T, Ching Chin-Lin, Shaw Margie Hodges
J Clin Ethics. 2023 Spring;34(1):58-68. doi: 10.1086/723323.
AbstractWe explore the various ethical challenges that arise during the practical implementation of an emergency resource allocation protocol. We argue that to implement an allocation plan in a crisis, a hospital system must complete five tasks: (1) formulate a set of general principles for allocation, (2) apply those principles to the disease at hand to create a concrete protocol, (3) collect the data required to apply the protocol, (4) construct a system to implement triage decisions with those data, and (5) create a system for managing the consequences of implementing the protocol, including the effects on those who must carry out the plan, the medical staff, and the general public. Here we illustrate the complexities of each task and provide tentative solutions, by describing the experiences of the Coronavirus Ethics Response Group, an interdisciplinary team formed to address the ethical issues in pandemic resource planning at the University of Rochester Medical Center. While the plan was never put into operation, the process of preparing for emergency implementation exposed ethical issues that require attention.
摘要
我们探讨了在紧急资源分配方案实际实施过程中出现的各种伦理挑战。我们认为，医院系统要在危机中实施分配计划，必须完成五项任务：（1）制定一套分配的一般原则；（2）将这些原则应用于手头的疾病，以创建具体的方案；（3）收集应用该方案所需的数据；（4）构建一个利用这些数据实施分诊决策的系统；（5）创建一个管理实施该方案后果的系统，包括对那些必须执行该计划的人员、医务人员和公众的影响。在此，我们通过描述冠状病毒伦理应对小组的经验来说明每项任务的复杂性并提供初步解决方案，该小组是一个跨学科团队，旨在解决罗切斯特大学医学中心大流行资源规划中的伦理问题。虽然该计划从未付诸实施，但为紧急实施做准备的过程暴露了一些需要关注的伦理问题。
