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Saopštenje pravičnosti etičkih odluka u odnosu raspodele medicinskih resursa unutar pandemije COVID-19
Press release the fairness of ethical decisions related to the allocation of medical resources within the COVID-19 pandemic
aEuropean University Cyprus, Cyprus, School of Medicine, Nicosia bResuscitacioni Savet Srbije, Novi Sad
e-adresa: office@resuscitatio.org.rs
Sažetak
Pravičnosti etičkih odluka u odnosu raspodele medicinskih resursa unutar pandemije COVID-19 Resuscitacioni Savet Srbije je razmatrao i doneo konsenzus mišljenja nacionalnih kurs direktora oblasti resuscitacione medicine o osnovnim principima raspodele resursa, a u odnosu na primenu mera resuscitacije i zbrinjavanje obolelih u uslovima pandemije. COVID-19 pandemija je širom sveta unutar svih segmenta života donela dosta promena, svakodnevnih izazova sa kojima se suočavamo, pa tako i u oblasti medicinske etike, koja je vrlo osetljiva oblast zbog specifičnosti koje su jedinstvene i različite u svakoj zemlji pojedinačno, uz snažne kulturološke, ekonomske, verske, medicinske, pravne i ostale diverzitete. Izazovi su ogromni, obzirom na trenutno nepostojanje specifične terapije, ograničenost raspoloživih resursa dijagnostike, intervencije i preventivnih mera. Pandemija je donela i potrebu stvaranja uslova primene "nesvakidašnjih" zahteva, mera i procedura zdravstvenog sistema i medicinskog zbrinjavanja, koja za sobom povlači i određenu reorganizaciju medicinskih intervencija i sistema zbrinjavanja, uključujući i mere obavezne lične zaštite, pridržavanje primene socijalne distance i sve higijenske procedure. Sveopšti etički principi, kao što su maksimalni benefit i podjednakost lečenja, uz davanje prioriteta onima sa najtežim stanjem je stvorilo potrebu stvaranja preporuka u etici koje su vezane za raspodelu medicinskih resursa u COVID-19 pandemiji, te su Eziekel et al. objavili šest načela koja se odnose na gore pomenuto u smislu: maksimalizovanje benefita, davanja prednosti zdravstvenim radnicima, trijaža van okvira osnove "prvog stizanja", reagovanja na nalaze, prepoznavanje učešća u istraživanjima, te primenu istovetnih principa kako kod COVID-19, tako i kod non-COVID-19 pacijenata.1 Pravedna alokacija ovih etičkih vrednosti i principa zahteva prilagodljive etičke okvire u zavisnosti od raspoloživih resursa i organizacije sistema zbrinjavanja.
Abstract
The fairness of ethical decisions related to the allocation of medical resources within the COVID-19 pandemic The Serbian Resuscitation Council discussed, considered, and adopted based on the National Course Director leaders opinion consensus in the field of resuscitation medicine about the basic principles of resource allocations, related to the application of resuscitation procedures and care of patients during the pandemics. The COVID-19 pandemic around the world has brought a lot of changes within all segments of life, we all are faced to everyday challenges, including ethics in medicine, which is a very sensitive area due to specifics that are unique and different in each country individually, with strong cultural, economic, religious, medical, legal, and other diversities. The challenges are enormous, given by the current lack of a specific therapy, by the limited resources available for diagnosis, intervention, and preventive measures. The pandemic also brought the need to create conditions for the application of "unusual" requirements, measures, and procedures of the healthcare system and medical care, which entails a certain reorganization of medical interventions and care systems, including mandatory personal protection measures, adherence to adequate social distance, and all hygienic procedures. General ethical principles, such as maximum benefit and equality of treatment, while giving priority to those with the most severe conditions, have created the need to create ethical recommendations related to the allocation of medical resources in the COVID-19 pandemic and Eziekel et al. published six principles related to the above in terms of maximizing benefits, giving an advantage to healthcare professionals, triage outside the framework of the "first arrival" basis, responding to findings, recognizing participation in research, and applying the same principles to COVID-19 and in non-COVID-19 patients. A fair allocation of these ethical values and principles requires adaptable ethical frameworks depending on the resources available and the organizational structure of the healthcare system.
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