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題名:大量傷患醫療資源分配之倫理思辨--以八仙塵爆為例
書刊名:護理雜誌
作者:唐景俠陳嘉容黃美智
作者(外文):Tang, Jing-shiaChen, Chia-jungHuang, Mei-chih
出版日期:2017
卷期:64:1
頁次:頁105-111
主題關鍵詞:大量傷患醫療資源倫理燒傷Mass casualty incidentMedical resourcesEthicalBurn
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:20
  • 點閱點閱:179
災難的發生無法預期,一旦發生常常造成大量傷患。當大量傷患產生時,有限的醫療資源往往不足以捍衛所有無價的生命,故在大量傷患產生時進行專業的檢傷分類,即是期望將醫療資源做最大效益之分配與應用,以拯救更多寶貴的生命。然因價值觀與立場不同,對於醫療資源的分配常有不同的看法與爭議。本文以2015年八仙塵爆事件為例,探討當時將醫療資源投注在燒燙傷面積90%以上與50–60%患者間之分配爭議與搶救順序。首先以西方倫理哲學之「效益論」與「義務論」為基礎,探討此事件中醫療資源分配的基本思維與合理性,接著以影響東方倫理至深之儒學為展延,觀察此次事件中多個「奇蹟」的發生,不僅只靠常設醫療資源的介入,更不能忽略社會中隱藏的助力。此事件中,外來物資與專業人力(社會資源)在當時自發性地投入搶救與支持,亦扮演著不容忽視的影響力。
Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources. The present article focused on the 2015 explosion at Formosa Fun Coast, a recreational water park in Bali, New Taipei City, Taiwan as a way to explore the dilemma over the triage and resource allocation for casualties with burns over 90% and 50-60% of their bodies. The principles of utilitarianism and deontology in Western medicine were used to discuss the reasons and rationale behind the allocation of medical resources during this incident. Confucianism, a philosophical mindset that significantly influences Taiwanese society today, was then discussed to describe the "miracles" that happened during the incident, including the acquisition of assistance from the public and medical professionals. External supplies and professional help (social resources) were provided voluntarily after this incident, which had a profound impact on both the immediate response and the longer-term recovery efforts.
期刊論文
1.Nocera, A.、Garner, A.(1999)。An Australian Mass Casualty Incident Triage System for the Future Based upon Triage Mistakes of the Past: the Homebush Triage Standard。ANZ Journal of Surgery,69(8),603-608。  new window
2.徐明儀、江蓮瑩(20140200)。無效醫療議題之探討。護理雜誌,61(1),99-104。new window  延伸查詢new window
3.陳祖裕(20030100)。無效醫療。應用倫理研究通訊,25,54-63。new window  延伸查詢new window
4.中華民國護理師護士公會全國聯合會(2015)。照護八仙塵爆病人心得分享。全聯護訊,106,16-32。  延伸查詢new window
5.劉淑瓊(2015)。燒燙傷醫療是公共財政府須介入分配。醫改季刊,62(3),7-8。  延伸查詢new window
6.蘇騰葳、周大為、方震中、蔡甫昌(20150900)。粉塵爆炸事件之緊急醫療倫理問題探討。臺灣醫學,19(5),508-516。  延伸查詢new window
7.De Boer, J.(1990)。Definition and classification of disaster: Introduction of a disaster severity scale。The Journal of Emergency Medicine,8(5),591-595。  new window
8.Geale, S. K.(2012)。The ethics of disaster management。Disaster Prevention and Management: An International Journal,21(4),445-462。  new window
9.Gunn, S. W. A.(1990)。The language of disasters。Prehospital and Disaster Medicine,5,373-376。  new window
10.Karadag, C. O.、Hakan, A. K.(2012)。Ethical dilemmas in disaster medicine。Iranian Red Crescent Medical Journal,14(10),602-612。  new window
11.Lee, C. H.(2010)。Disaster and mass casualty triage。AMA Journal of Ethics,12(6),466-470。  new window
12.Osier, T.、Glance, L. G.、Hosmer, D. W.(2010)。Simplified estimates of the probability of death after burn injuries: Extending and updating the baux score。The Journal of Trauma® Injury, Infection, and Critical Care,68(3),690-697。  new window
13.Sztajnkrycer, M. D.、Madsen, B. E.、Baez, A. A.(2006)。Unstable ethical plateaus and disaster triage。Emergency Medicine Clinics of North America,24,749-768。  new window
14.Taylor, S.、Jeng, J.、Saffle, J. R.、Sen, S.、Greenhalgh, D. G.、Palmieri, T. L.(2014)。Redefining the outcomes to resources ratio for bum patient triage in a mass casualty。Journal of Bum Care & Research,35(1),4-5。  new window
研究報告
1.衛生福利部統計處(20160517)。103年醫院概況--表48醫院病床數--按權屬別分。  延伸查詢new window
學位論文
1.羅智韋(2005)。道德判斷之根據:康德與孟子的道德思考及其教育意義(碩士論文)。國立政治大學。  延伸查詢new window
圖書
1.Beauchamp, Tom L.、Childress, James Franklin(2013)。Principles of Biomedical Ethics。Oxford University Press。  new window
2.林志豪(2010)。災難最前線--緊急醫療系統的運作。臺北市:貓頭鷹。new window  延伸查詢new window
3.Singer, Peter A.、蔡甫昌(2009)。臨床生命倫理學。臺北:財團法人醫院評鑑暨醫療品質策進會。  延伸查詢new window
4.王宗倫、石富元、陳輝財(2005)。災難醫學精要。新北市:金名圖書。  延伸查詢new window
5.李鍌(2008)。中國文化基本教材:論語。新北市:正中書局。  延伸查詢new window
6.明德出版社(2013)。孟子:白話譯註。新北市:明德出版社。  延伸查詢new window
7.衛生福利部(2016)。不計代價全力搶救--八仙粉塵暴燃衛福總動員。  延伸查詢new window
8.Kant, I.、Ellington, J. W.(1995)。Kant: Ethical philosophy: Grounding for the metaphysics of morals, and, metaphysical principles of virtue, with, "On a supposed right to lie because of philanthropic concerns"。Indianapolis, IN:Hackett Publishing。  new window
9.Edwards, S. D.(2009)。Nursing ethics: A principle-based approach。London, UK:Palgrave Macmillan。  new window
10.林火旺(2004)。倫理學。臺北市:五南。  延伸查詢new window
其他
1.ReliefWeb.(2008)。Glossary of humanitarian terms,http://reliefweb.int/sites/reliefweb.int/files/resources/4F99A3C28EC37DOEC12574A4002E89B4-reliefweb_aug2008.pdf。  new window
 
 
 
 
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