Professionally responsible advocacy for women and children first during the COVID-19 pandemic: guidance from World Association of Perinatal Medicine and International Academy of Perinatal Medicine
Professionally responsible advocacy for women and children first during the COVID-19 pandemic: guidance from World Association of Perinatal Medicine and International Academy of Perinatal Medicine
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DOI：
10.1515/jpm-2020-0329
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发表时间：
2020-11-01
影响因子：
2.4
通讯作者：
Kurjak, Asim
中科院分区：
文献类型：
--
作者：
Chervenak, Frank A.;McCullough, Laurence B.;Kurjak, Asim
围产期医学的目标是为孕妇、胎儿和新生儿的病情和诊断提供专业负责的临床管理。国际围产期医学学会纽约宣言：“妇女和儿童优先--还是最后？”是针对中等收入和低收入国家围产期医学的伦理挑战。全球新冠肺炎疫情给所有国家带来了共同的道德挑战，与它们的国民财富无关。在这篇论文中，世界围产期医学协会为在新冠肺炎大流行期间首先对妇女和儿童进行专业负责的倡导提供了基于伦理的指导。我们首先提出一个伦理框架，解释伦理推理、临床相关的伦理原则和职业美德，以及与怀孕患者和父母的决策。然后，我们将这一道德框架应用于循证治疗及其改善、有计划的家庭分娩、围栏产科服务、配偶或伴侣出生时的护理以及组织资源的负责任管理。围产期医生应该专注于围产期医学的使命，将妇女和儿童放在首位，并在必要时进行框架转换，将医院服务的患者的生命和健康放在首位。
The goal of perinatal medicine is to provide professionally responsible clinical management of the conditions and diagnoses of pregnant, fetal, and neonatal patients. The New York Declaration of the International Academy of Perinatal Medicine, "Women and children First - or Last?" was directed toward the ethical challenges of perinatal medicine in middle-income and low-income countries. The global COVID-19 pandemic presents common ethical challenges in all countries, independent of their national wealth. In this paper the World Association of Perinatal Medicine provides ethics-based guidance for professionally responsible advocacy for women and children first during the COVID-19 pandemic. We first present an ethical framework that explains ethical reasoning, clinically relevant ethical principles and professional virtues, and decision making with pregnant patients and parents. We then apply this ethical framework to evidence-based treatment and its improvement, planned home birth, ring-fencing obstetric services, attendance of spouse or partner at birth, and the responsible management of organizational resources. Perinatal physicians should focus on the mission of perinatal medicine to put women and children first and frame-shifting when necessary to put the lives and health of the population of patients served by a hospital first.