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Impact of restricted family presence during the COVID-19 pandemic on critically ill patients, families, and critical care clinicians: a qualitative systematic review.COVID-19 大流行期间限制家属探视对危重症患者、家属和重症监护临床医生的影响:定性系统评价。
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新冠疫情时代医院探视禁令的法律与伦理维度

The Legal and Ethical Dimensions of Hospital Visitation Bans in the COVID-19 Era.

作者信息

Lassi Nicholas, Jiang Su, Du Yu

机构信息

School of Law, Southwest University of Political Science and Law, Chongqing 401120, China.

Law School, Peking University, Beijing 100871, China.

出版信息

Healthcare (Basel). 2025 Jan 31;13(3):288. doi: 10.3390/healthcare13030288.

DOI:10.3390/healthcare13030288
PMID:39942477
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11817412/
Abstract

The COVID-19 pandemic compelled countries worldwide to implement stringent visitation restrictions across hospitals, nursing homes, and long-term care facilities to mitigate viral transmission. While initially justified by the uncertainty surrounding the virus, these restrictions often lasted well beyond the acute stage of the pandemic, leading to substantial psychological and physical harm, particularly for older adults. This study assesses the effects of these controls and offers strategies to balance public health priorities with patients' rights and psychological well-being during public health crises. An integrative review and comparative analysis of legislative measures and the psychological effects of visitation restrictions was undertaken. International and national visitation regulations and case studies were reviewed, and ethical frameworks were considered. Our findings indicate that prolonged isolation due to extended visitation restrictions led to higher rates of anxiety, depression, and delirium among patients, creating ethical dilemmas for healthcare providers. Legal responses to this challenge varied globally. International human rights organizations called for policies bridging public health priorities with patients' rights to family and caregiver support. Some U.S. states enacted proactive legislation to strengthen family visitation rights, while other jurisdictions lack these visitation protections. Prolonged visitation restrictions during the pandemic show the need for legislation integrating public health protections with in-person family and caregiver support. The ethical imperatives of limiting the psychological harm caused by healthcare isolation and the legislative solutions to protect public health and the psychological well-being of patients during health crises are discussed.

摘要

新冠疫情迫使世界各国在医院、养老院和长期护理机构实施严格的探视限制,以减轻病毒传播。虽然这些限制最初因病毒的不确定性而合理,但往往持续到疫情急性期之后很久,对人们造成了巨大的心理和身体伤害,尤其是对老年人。本研究评估了这些管控措施的影响,并提出了在公共卫生危机期间平衡公共卫生优先事项与患者权利及心理健康的策略。我们对立法措施以及探视限制的心理影响进行了综合回顾和比较分析。审查了国际和国家的探视规定及案例研究,并考虑了伦理框架。我们的研究结果表明,由于延长探视限制导致的长期隔离,使患者焦虑、抑郁和谵妄的发生率更高,给医疗服务提供者带来了伦理困境。全球对此挑战的法律应对各不相同。国际人权组织呼吁制定政策,在公共卫生优先事项与患者获得家人和照护者支持的权利之间架起桥梁。美国一些州颁布了积极的立法以加强家庭探视权,而其他司法管辖区则缺乏这些探视保护措施。疫情期间长期的探视限制表明,需要制定将公共卫生保护与亲自探视家人和照护者支持相结合的立法。文中讨论了限制医疗隔离造成的心理伤害的伦理必要性,以及在健康危机期间保护公众健康和患者心理健康的立法解决方案。