Yeh Ming-Jui, Lee Po-Han
Ming-Jui Yeh, PhD, is Assistant Professors, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan.
Po-Han Lee, PhD, is Assistant Professors, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan.
Health Secur. 2023 Sep-Oct;21(5):371-378. doi: 10.1089/hs.2023.0003. Epub 2023 Aug 7.
Scholars have called for ethical preparedness for public health practice and research to address the challenges of special ethical considerations under time and resource pressure during emergencies like the COVID-19 pandemic. We propose the idea of a rapid ethical assessment (REA) that aims to provide ethical justifications and policy recommendations for a specific public health policy, which is necessary for the ethical legitimacy of health policymaking and implementation. We suggest that an REA task force be established and incorporated into the administrative procedure to perform an REA in the early, middle, and terminal stages of a policy proposed by the health authority and to determine to what extent the tradeoffs between values and priorities required by the policy are ethically acceptable. The REA task force's role is consultative, with the final decisionmaking power and political responsibilities falling on the health authority. The REA task force should adopt 4 substantial ethical principles: utilitarianism, equity, human rights, and solidarity. The REA task force would consist of a multidisciplinary team of experts and a group of representatives from those who would be affected by the proposed policy. The REA task force would operate with a 5-step procedure of (1) convening, (2) investigation, (3) determination, (4) reporting and communication, and (5) decision and reassessment. We use 2 real incidents in Taiwan to demonstrate how the REA task force could work to enhance the ethical acceptance of a policy.
学者们呼吁为公共卫生实践和研究做好伦理准备，以应对像新冠疫情这样的紧急情况下，在时间和资源压力下特殊伦理考量所带来的挑战。我们提出了快速伦理评估（REA）的理念，其旨在为一项特定的公共卫生政策提供伦理依据和政策建议，这对于卫生政策制定和实施的伦理合法性而言是必要的。我们建议成立一个快速伦理评估特别工作组，并将其纳入行政程序，以便在卫生当局提出的政策的早期、中期和末期阶段进行快速伦理评估，并确定该政策所要求的价值与优先事项之间的权衡在何种程度上在伦理上是可接受的。快速伦理评估特别工作组的作用是咨询性的，最终决策权和政治责任落在卫生当局身上。快速伦理评估特别工作组应采用四项实质性伦理原则：功利主义、公平、人权和团结。快速伦理评估特别工作组将由一个多学科专家团队以及一群受拟议政策影响的人的代表组成。快速伦理评估特别工作组将按照五个步骤开展工作：（1）召集，（2）调查，（3）确定，（4）报告与沟通，以及（5）决策与重新评估。我们用台湾的两起真实事件来说明快速伦理评估特别工作组如何能够努力提高一项政策的伦理可接受性。
