Emergency department triage: an ethical analysis

BMC Emergency Medicine

Debate

Yvonne Denier¹  Chris Gastmans¹  Ramesh P Aacharya² 

[1] Centre for Biomedical Ethics and Law, Faculty of Medicine, Catholic University, Leuven, Belgium;Department of General Practice & Emergency Medicine, Tribhuvan University Teaching Hospital, P. O. Box 8844, Maharajgunj, Kathmandu, Nepal;

关键词: Emergency Department;    Emergency Care;    Severe Acute Respiratory Syndrome;    Ethical Analysis;    Triage System;   

DOI  :  10.1186/1471-227X-11-16

 received in 2010-11-23, accepted in 2011-10-07,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundEmergency departments across the globe follow a triage system in order to cope with overcrowding. The intention behind triage is to improve the emergency care and to prioritize cases in terms of clinical urgency.DiscussionIn emergency department triage, medical care might lead to adverse consequences like delay in providing care, compromise in privacy and confidentiality, poor physician-patient communication, failing to provide the necessary care altogether, or even having to decide whose life to save when not everyone can be saved. These consequences challenge the ethical quality of emergency care. This article provides an ethical analysis of "routine" emergency department triage. The four principles of biomedical ethics - viz. respect for autonomy, beneficence, nonmaleficence and justice provide the starting point and help us to identify the ethical challenges of emergency department triage. However, they do not offer a comprehensive ethical view. To address the ethical issues of emergency department triage from a more comprehensive ethical view, the care ethics perspective offers additional insights.SummaryWe integrate the results from the analysis using four principles of biomedical ethics into care ethics perspective on triage and propose an integrated clinically and ethically based framework of emergency department triage planning, as seen from a comprehensive ethics perspective that incorporates both the principles-based and care-oriented approach.

【 授权许可】

CC BY   
© Aacharya et al; licensee BioMed Central Ltd. 2011