Balancing the duty to treat with the duty to family in the context of the COVID-19 pandemic
Balancing the duty to treat with the duty to family in the context of the COVID-19 pandemic
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DOI：
10.1136/medethics-2020-106250
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发表时间：
2020-06-01
影响因子：
4.1
通讯作者：
McConnell, Doug
中科院分区：
文献类型：
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作者：
McConnell, Doug
在COVID-19大流行期间，全球各地的医疗保健系统正努力维持足够的劳动力以提供充足的护理。医护人员因担心家人而拒绝工作，加剧了人员配备问题。我勾勒出一个义务论的框架，评估当它是道德上允许的医务人员放弃工作，以保护他们的家人免受感染，当它是一个失职的病人。我认为，这是道德上允许的HCWs放弃工作时，他们的责任，治疗是超过了综合风险和负担的工作。对于与家人住在一起的医务工作者来说，保护家人免受感染的义务大大加重了他们的负担。然而，还有一系列复杂的因素，包括根据医务妇女的角色而不同的治疗责任的强度、家庭成员对疾病的脆弱性、家庭成员冒感染风险的意愿以及医务妇女可用于保护其家庭的资源。在许多情况下，考虑到COVID-19带来的风险，处于“前线”角色的医务工作者的治疗责任较弱，而家中的家庭在道德上将被允许放弃工作;因此，社会应提供额外的激励措施，以维持足够的员工担任这些角色。
Healthcare systems around the world are struggling to maintain a sufficient workforce to provide adequate care during the COVID-19 pandemic. Staffing problems have been exacerbated by healthcare workers (HCWs) refusing to work out of concern for their families. I sketch a deontological framework for assessing when it is morally permissible for HCWs to abstain from work to protect their families from infection and when it is a dereliction of duty to patients. I argue that it is morally permissible for HCWs to abstain from work when their duty to treat is outweighed by the combined risks and burdens of that work. For HCWs who live with their families, the obligation to protect one's family from infection contributes significantly to those burdens. There are, however, a range of complicating factors including the strength of duty to treat which varies according to the HCW's role, the vulnerability of family members to the disease, the willingness of family members to risk infection and the resources available to the HCW to protect their family. In many cases, HCWs in 'frontline' roles with a weak duty to treat and families at home will be morally permitted to abstain from work given the risks posed by COVID-19; therefore, society should provide additional incentives to maintain sufficient staff in these roles.