Structural Inequities, Fair Opportunity, and the Allocation of Scarce ICU Resources.
Structural Inequities, Fair Opportunity, and the Allocation of Scarce ICU Resources.
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结构性不平等、公平机会和稀缺 ICU 资源的分配。
DOI：
10.1002/hast.1285
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Lo,Bernard
中科院分区：
文献类型：
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作者：
White,DouglasB;Lo,Bernard
2021年9月至10月期的《黑斯廷斯中心报告》重点阐述了在新冠肺炎大流行期间分配稀缺重症护理资源的重要主题。Alex Rajczi及其同事的文章敦促政策制定者在制定分流政策时使用公共推理，而不是私人推理。我们完全同意。我们展示了我们作为私人学者开发的分配框架，“匹兹堡框架”，如何得到公众推理的支持。MaryKatherine Gaurke及其同事的文章批评了基于最大化挽救生命年的配给，并错误地声称我们的框架推荐了这种方法。我们解释说，我们的框架从未包含这样的标准，而是包括了对近期预后的更有限的考虑。2020年12月，为回应新数据和重要批评，我们修改了框架，以进一步加强公平性。我们致力于通过反思性讨论和辩论，改进危机期间的分配准则和护理标准。
The September‐October 2021 issue of theHastings Center Reporthighlights the important topic of allocating scarce critical care resources during the Covid‐19 pandemic. The article by Alex Rajczi and colleagues urges that policy‐makers use public reasoning, not private reasoning, when developing triage policies. We completely agree. We show how the allocation framework we developed as private scholars, the “Pittsburgh framework,” has been supported by public reasoning.The article by MaryKatherine Gaurke and colleagues criticizes rationing based on maximizing life‐years saved and mistakenly claims that our framework recommended this approach. We explain that our framework never contained such a criterion but instead included a more limited consideration of near‐term prognosis. In December 2020, in response to emerging data and important criticisms, we modified our framework to further strengthen equity. We are committed to improving allocation guidelines during crisis standards of care through reflective discussions and debates.