Children, acceptable health risks and COVID-19: Ethical guidance for a fair policy response

为了应对这一流行病，国家保健服务体系部署了一些战略（例如，限制常规服务、改变护理服务、重新部署工作人员和诊所空间），这些战略对儿童的日常护理产生了直接影响。迄今为止，据记录，Covid-19感染对儿童身体健康的直接影响远小于对其他群体的影响。相比之下，对儿童的间接影响是深远的，医院的紧急活动大幅减少（von Dadelszen, Khalil， Wolfe等人，2020年英国医学杂志）。目前还没有已知的研究评估卫生服务的限制和保健服务的变化在多大程度上对儿童公平。该项目由NHS儿童保健专家合作开展，旨在解决在Covid-19相关研究和政策中遗漏的与儿童相关的伦理层面问题。为实现这一目标，它将探讨在卫生系统应对大流行的过程中，哪些儿童身心健康风险在道德上是合理的。该项目将向医疗当局和政府部门提供无障碍的道德指导，说明在大流行背景下，长期患病儿童的需求应如何在确定优先次序的过程中发挥重要作用。将与负责就资源分配问题作出决定的一系列决策者一起，并与伦敦东南部的临床-学术儿童和青少年健康伙伴关系密切合作，在具体情况下评估这项指导意见。

To respond to the pandemic the NHS deployed strategies (e.g. usual service restriction, changes in care delivery, redeployment of staff and clinic space) which had an immediate effect on children's usual care. To date, the direct impact of Covid-19 infection on children's physical health has been recorded as being far milder than for other groups. By contrast the indirect impact on children has been profound, with substantial reductions in urgent activity in hospitals (von Dadelszen, Khalil, Wolfe et al. 2020 BMJ). There are no known studies which assess the extent to which health service restrictions and changes in care delivery are fair for children.This project, undertaken in collaboration with NHS child healthcare specialists, aims to address the omission of a children-related ethical dimension in Covid-19 related research and policy. It will achieve this by exploring which risks on children's physical and mental health can be morally justified in health systems' response to the pandemic. This project will provide accessible ethical guidance to medical authorities and government departments on how the needs of children with long-term conditions should feature in the prioritisation process required in the pandemic context. This guidance will be assessed, in context, in conjunction with a range of decision-makers who are responsible for making decisions about the allocation to resources and by working closely with the clinical-academic Children and Young People's Health Partnership (CYPHP) in South East London.