Public Health Ethics and Clinical Practice in the Context of Response to the Outbreak of an Infectious Disease
-
摘要: 公共卫生的宗旨是组织全体社会成员共同努力预防和控制疾病、促进健康。医务工作者和医疗机构是公共卫生系统不可或缺的重要组成部分,了解公共卫生伦理学的概念和原则,有助于改进医疗决策、提升医疗质量。医务工作者的临床实践既要符合临床伦理学原则,又要兼顾公共卫生伦理学原则,尤其在突发重大疫情背景下,公共卫生伦理学在临床诊疗和医疗资源分配中的意义更为突出。本文从实践出发,分析公共卫生伦理学与临床伦理学的区别与联系,并探讨临床医务工作者在应对突发重大传染病疫情时可能面临的公共卫生伦理应用场景。Abstract: Public health focuses on collective actions to address the health needs of populations. Public health ethics helps to guide the practice of public health with ethical principles and norms. As healthcare providers, medical workers and healthcare facilities are integral parts of the public health system. Daily clinical practice involves principles of not only clinical medical ethics but also public health ethics. In the context of combating the outbreak of an infectious disease, public health ethics plays a significant role in clinical practice. We briefly overview the definition and principles of public health ethics, and introduce three substantive ethical questions that are central to public health and may be encountered in clinical practice.作者贡献:谢静负责资料收集及文章撰写;吴东负责文章撰写;张抒扬负责文章审校。利益冲突 无
-
[1] World Health Organization.Coronavirus disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update[EB/OL ].(2020-11-23).https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. [2] 翟晓梅, 邱仁宗.公共卫生伦理学的结构和若干基论题[J].医学与哲学, 2017, 38:1-5. Zhai XM, Qiu RZ.The Structure and Basic Topics of Public Health Ethics[J].Yi Xue Yu Zhe Xue, 2017, 38:1-5. [3] 曾光, 黄建始.公共卫生的定义和宗旨[J].中华医学杂志, 2010, 90:367-370. doi: 10.3760/cma.j.issn.0376-2491.2010.06.003 Zeng G, Huang JS.Understanding the definition and the mission of public health correctly[J]. Zhonghua Yi Xue Za Zhi, 2010, 90:367-370. doi: 10.3760/cma.j.issn.0376-2491.2010.06.003 [4] Institute of Medicine.The Future of Public Health[M].Washington(DC): the National Academies Press, 1988: 1-2. [5] Siegler M.Clinical Medical Ethics: Its History and Contributions to American Medicine[J].J Clin Ethics, 2019, 30:17-26. [6] Jonsen AR, Siegler M, Winslade WJ.Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine[M].8th ed. New York: McGraw-Hill Education, 2015: 3-4. [7] İlgüy M, İlgüy D, Oktayİ.Ethical decision making in dental education: a preliminary study[J].BMC Med Ethics, 2015, 16: 52. doi: 10.1186/s12910-015-0046-4 [8] Chu DK, Akl EA, Duda S, et al.Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis[J].Lancet, 2020, 395:1973-1987. doi: 10.1016/S0140-6736(20)31142-9 [9] Centers for Disease Control and Prevention.Considerations for Wearing Cloth Face Coverings: Help Slow the Spread of COVID-19[EB/OL]. (2020-11-12). https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html. [10] 张海洪, 丛亚丽.世界卫生组织《公共卫生监测伦理指南》要点及启示[J].医学与哲学, 2018, 39:26-28, 36. Zhang HH, Cong YL.Introduction and Reflections on WHO Ethical Guidelines of Public Health Surveillance[J].Yi Xue Yu Zhe Xue, 2018, 39:26-28, 36. [11] 中华人民共和国中央人民政府.《中华人民共和国传染病防治法》[EB/OL].(2005-05-25).http://www.gov.cn/banshi/2005-05/25/content_971.htm. [12] 国家卫生计生委办公厅.《关于印发全国医疗机构卫生应急工作规范(试行)和全国疾病预防控制机构卫生应急工作规范(试行)的通知》[EB/OL].(2015-11- 09). http://www.nhc.gov.cn/yjb/s7859/201511/8b520f79cba04976bd563ab22bd0fc69.shtml. [13] World Health Organization.WHO guidelines on ethical issues in public health surveillance[M/OL].https://www.who.int/ethics/publications/public-health-surveillance/en/. [14] 赵彩飞, 刘宇.突发公共卫生事件时正确适用知情同意探讨[J].中华医院管理杂志, 2020, 36:302-306. Zhao CF, Liu Y.Discussion on correct application of informed consent in public health emergency management[J].Zhonghua Yi Yuan Guan Li Za Zhi, 2020, 36:302-306. [15] Emanuel EJ, Persad G, Upshur R, et al.Fair Allocation of Scarce Medical Resources in the Time of COVID-19[J].N Engl J Med, 2020, 382:2049-2055. doi: 10.1056/NEJMsb2005114 [16] 世界卫生组织.传染病暴发伦理问题管理指南[M].熊宁宁, 刘海涛, 伍蓉, 等译.北京: 中国中医药出版社, 2020: 24-26. [17] 张抒扬.加强公立综合性医院突发公共卫生事件应急能力建设[J].协和医学杂志, 2020, 11:641-644. doi: 10.3969/j.issn.1674-9081.2020.06.002 Zhang SY. Strengthening Preparedness for Public Health Emergency and Response Capabilities of Public Academic Medical Centers[J].Xie He Yi Xue Za Zhi, 2020, 11:641-644. doi: 10.3969/j.issn.1674-9081.2020.06.002
点击查看大图
计量
- 文章访问数: 917
- HTML全文浏览量: 264
- PDF下载量: 51
- 被引次数: 0