Pandemic influenza preparedness: an ethical framework to guide decision-making.
Pandemic influenza preparedness: an ethical framework to guide decision-making.
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DOI：
10.1186/1472-6939-7-12
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发表时间：
2006-12-04
影响因子：
2.7
通讯作者：
Upshur RE
中科院分区：
文献类型：
--
作者：
Thompson AK;Faith K;Gibson JL;Upshur RE
世界各地的医院正在为下一次大流行性流感爆发做准备。全球SARS的经验告诉我们，指导决策的道德框架可能有助于减少附带损害，并增加医疗机构内部和之间的信任和团结。良好的流行病规划需要对价值观进行反思，因为单靠科学无法告诉我们如何为公共卫生危机做好准备。在本文中，我们提出了一个大流行性流感规划的伦理框架。道德框架是利用临床、组织和公共卫生道德方面的专业知识制定的，并通过利益相关者参与过程进行了验证。伦理框架包括流感大流行伦理规划的实质性和程序性要素。将伦理纳入流行病规划可以通过以下方式来帮助：高级医院管理人员赞助其使用，让利益相关者审查框架，以及设计或确定决策审查流程。我们讨论的优点和局限性的应用伦理框架的医院决策，以及该框架的鲁棒性。对大流行性流感爆发的幽灵所引起的伦理问题进行反思是非常必要的。我们努力解决医院流行病规划的规范问题，引起了其他医院和政府部门的兴趣。该框架需要重新评估和完善，我们希望本文将产生关于如何使其更加强大的反馈。
Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust.