[Ethical, deontologic and legal considerations about SIAARTI Document "Clinical ethics recommendations for the allocation of intensive care treatments, in exceptional, resource-limited circumstances".]
[Ethical, deontologic and legal considerations about SIAARTI Document "Clinical ethics recommendations for the allocation of intensive care treatments, in exceptional, resource-limited circumstances".]
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DOI：
10.1701/3347.33184
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发表时间：
2020-04-01
影响因子：
--
通讯作者：
Rodriguez, Daniele
中科院分区：
文献类型：
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作者：
Piccinni, Mariassunta;Aprile, Anna;Rodriguez, Daniele
2020年3月6日，意大利麻醉镇痛复苏和重症监护学会（SIAARTI）发布了《在需求和可用资源不平衡的特殊情况下接受和暂停重症监护的临床伦理建议》文件。该文件旨在提出在保健需求和现有资源之间存在异常不平衡的情况下的治疗决策标准，在医学科学界、学术界和媒体中引起了强烈反应。在当前由CoViD-19疫情引起的国际公共卫生紧急情况下，这项工作旨在解释SIAARTI文件的伦理、义务和法律的基础，并提出有助于理解和放置背景下的决策标准的方法论和论证性整合。为起草本文件做出贡献的工作组一致认为，特别致力于照顾目前需要重症监护或亚重症监护的患者的医护人员应该受益于有助于指导护理的明确操作指示，同时，人们应该事先知道，哪些标准将指导我们每个人可能面临的悲惨选择。因此，这一贡献首先反映了SIAARTI的立场和SIAARTI文件的目标的适当性。然后，它转而说明如何在跨学科、伦理、义务和法律的共同视角内提出建议。
On 6 March 2020, the Italian Society of Anaesthesia Analgesia Resuscitation and Intensive care (SIAARTI) published the document "Clinical Ethics Recommendations for Admission to and Suspension of Intensive Care in Exceptional Conditions of Imbalance between Needs and Available Resources". The document, which aims to propose treatment decision-making criteria in the face of exceptional imbalances between health needs and available resources, has produced strong reactions, within the medical-scientific community, in the academic world, and in the media. In the current context of international public health emergency caused by the CoViD-19 epidemic, this work aims to explain the ethical, deontological and legal bases of the SIAARTI Document and to propose methodologic and argumentative integrations that are useful for understanding and placing in context the decision-making criteria proposed. The working group that contributed to the drafting of this paper agrees that it is appropriate that healthcare personnel, who is particularly committed to taking care of those who are currently in need of intensive or sub-intensive care, should benefit from clear operational indications that are useful to orient care and, at the same time, that the population should know in advance which criteria will guide the tragic choices that may fall on each one of us. This contribution therefore firstly reflects on the appropriateness of the SIAARTI standpoint and the objectives of the SIAARTI Document. It then turns to demonstrate how the recommendations it proposes can be framed within a shared interdisciplinary, ethical, deontological and legal perspective.