Harvey Dan, Gardiner Dale, McGee Andrew, DeBeer Thearina, Shaw David
Nottingham University Hospitals NHS Trust, Nottingham, UK.
Faculty of Law, Queensland University of Technology, Brisbane, Australia.
J Intensive Care Soc. 2022 Feb;23(1):70-77. doi: 10.1177/1751143720950542. Epub 2020 Aug 27.
CRITCON-Pandemic levels with an associated operational responsibility matrix were recently published by the Intensive Care Society as a modification to Winter Flu CRITCON levels, to better account for differences between a winter flu surge in critical care activity and the capacity challenges of the COVID-19 pandemic. In this paper, we propose an expansion and explanation of the operational matrix to suggest a stepwise ethical approach to clinician responsibility. We propose and outline the main ethical risks created at each level and discuss how those risks can be mitigated through a balanced application of the predominant ethical principle which in turn provides practical guidance to clinician responsibility. We thus seek to specify the ethical and legal principles that should be used in applying the operational matrix, and what the practical effects could be.
重症监护协会最近发布了带有相关操作责任矩阵的CRITCON-大流行级别，作为对冬季流感CRITCON级别的修改，以更好地说明重症监护活动中冬季流感激增与COVID-19大流行的能力挑战之间的差异。在本文中，我们提议对操作矩阵进行扩展和解释，以提出一种针对临床医生责任的逐步伦理方法。我们提出并概述了每个级别产生的主要伦理风险，并讨论了如何通过平衡应用主要伦理原则来减轻这些风险，这反过来又为临床医生责任提供了实际指导。因此，我们试图明确在应用操作矩阵时应使用的伦理和法律原则，以及可能产生的实际效果。
