把疾病消灭在萌芽状态?“疾病拦截”概念的伦理和社会考虑。

IF 1.4 3区 哲学 Q2 ETHICS Public Health Ethics Pub Date : 2021-03-15 eCollection Date: 2021-04-01 DOI:10.1093/phe/phaa036
Jonas Narchi, Eva C Winkler
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引用次数: 0

摘要

“疾病拦截”描述了在临床不明显阶段对疾病的治疗,在医学文献中越来越多地使用。然而,目前还没有精确的定义,更不用说道德评价了。本文首先将“疾病拦截”的定义与其他预防区分开来。然后,根据比彻姆和柴尔德里斯提出的医学伦理四原则,分析了这一概念的伦理和社会含义。术语“疾病拦截”是指在短期拦截窗口中应用的一种二级预防形式,旨在防止临床前疾病进一步发展。我们提出了“通过治疗进行早期和有针对性的二级预防”的定义。对这一概念的伦理评估表明,虽然它有望有益,但它在患者自主和正义方面提出了一些伦理和社会挑战。为了确保决策尊重患者的自主权,诸如“疾病拦截”之类出于商业动机的隐喻应该让位于精确的定义。未来的研究不仅应该关注如何检测临床不明显的疾病,还应该关注伦理问题,什么时候这样做是合理的,以及它对个人和整个社会会产生什么后果。
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Nipping Diseases in the Bud? Ethical and Social Considerations of the Concept of 'Disease Interception'.

'Disease interception' describes the treatment of a disease in its clinically inapparent phase and is increasingly used in medical literature. However, no precise definition, much less an ethical evaluation, has been developed yet. This article starts with a definition of 'disease interception' by distinguishing it from other preventions. It then analyses the ethical and social implications of the concept in light of the four principles of medical ethics by Beauchamp and Childress. The term 'disease interception' refers to a form of secondary prevention applied in a short interception window intended to prevent a preclinical disease from developing further. We propose the definition 'early and targeted secondary prevention by treatment'. The ethical evaluation of the concept shows that while it promises to be beneficial, it raises a number of ethical and social challenges regarding patient autonomy and justice. In order to ensure decision-making that respects patient autonomy, commercially motivated metaphors such as 'disease interception' should make way for precise definitions. Future research should not only focus on how to detect clinically inapparent diseases but also on the ethical question, when this is justifiable and what consequences it has for the individual and society as a whole.

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来源期刊
Public Health Ethics
Public Health Ethics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-MEDICAL ETHICS
CiteScore
3.10
自引率
9.50%
发文量
28
审稿时长
>12 weeks
期刊介绍: Public Health Ethics invites submission of papers on any topic that is relevant for ethical reflection about public health practice and theory. Our aim is to publish readable papers of high scientific quality which will stimulate debate and discussion about ethical issues relating to all aspects of public health. Our main criteria for grading manuscripts include originality and potential impact, quality of philosophical analysis, and relevance to debates in public health ethics and practice. Manuscripts are accepted for publication on the understanding that they have been submitted solely to Public Health Ethics and that they have not been previously published either in whole or in part. Authors may not submit papers that are under consideration for publication elsewhere, and, if an author decides to offer a submitted paper to another journal, the paper must be withdrawn from Public Health Ethics before the new submission is made. The editorial office will make every effort to deal with submissions to the journal as quickly as possible. All papers will be acknowledged on receipt by email and will receive preliminary editorial review within 2 weeks. Papers of high interest will be sent out for external review. Authors will normally be notified of acceptance, rejection, or need for revision within 8 weeks of submission. Contributors will be provided with electronic access to their proof via email; corrections should be returned within 48 hours.
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