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COVID-19 伦理:截至 2024 年初的独特方面和综述。

COVID-19 ethics: unique aspects and a review as of early 2024.

机构信息

Baylor College of Medicine, Houston, TX, USA.

出版信息

Monash Bioeth Rev. 2024 Jun;42(1):55-86. doi: 10.1007/s40592-024-00199-x. Epub 2024 Jul 13.

Abstract

COVID-19 presents a variety of ethical challenges in a set of arenas, arenas not always considered in past pandemics. These challenges include issues related to autonomy, distributive ethics, and the establishment of policies of equity and justice. Methods are a literature review based on regular editing of an online textbook during the COVID-19 outbreak and a literature review using key ethical terms. Patients are confronted with new issues related to autonomy. Providers need to expand their concepts of ethical issues to include decisions based on proportionality and public health ethics. The public health sector needs to assess the beneficence of alternative modes of disease control. The research community needs to redefine the concept of informed consent in emergent conditions. All elements of the medical spectrum-physicians, scientists, and the community-at-large including the pharmaceutical industry-need to consider the multifaceted methods for preventing future pandemics. This will require giving particular emphasis to public health funding and ending the documented discrimination that exists in the provision of proven therapies. The developing world is especially at risk for most of the ethical issues, especially those related to equity and justice. The ethical issues associated with the COVID-19 outbreak are not unique but provide a diverse set of issues that apply to patients, providers, social groups, and investigators. The further study of such issues can help with preventing future outbreaks.

摘要

COVID-19 在一系列领域带来了各种伦理挑战,这些挑战在过去的大流行中并不总是被考虑到。这些挑战包括与自主性、分配伦理以及公平和正义政策的制定有关的问题。方法是在 COVID-19 爆发期间对在线教科书进行定期编辑的基础上进行文献回顾,并使用关键伦理术语进行文献回顾。患者面临与自主性相关的新问题。提供者需要扩大他们对伦理问题的概念,包括基于相称性和公共卫生伦理的决策。公共卫生部门需要评估替代疾病控制模式的益处。研究界需要在紧急情况下重新定义知情同意的概念。医疗领域的所有要素——医生、科学家和广大社区,包括制药行业——都需要考虑预防未来大流行的多方面方法。这将需要特别强调公共卫生资金,并结束在提供已证明有效的疗法方面存在的有记录的歧视。发展中国家面临着大多数伦理问题的特别风险,尤其是那些与公平和正义有关的问题。与 COVID-19 爆发相关的伦理问题并非独一无二,但提供了一系列适用于患者、提供者、社会团体和研究人员的多样化问题。对这些问题的进一步研究有助于预防未来的爆发。

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