加拿大安大略省制定急重症照護資源分配指引之經驗

The Experience of Developing Critical Care Resources Allocation Guidelines in Ontario, Canada

10.6320/FJM.202409_28(5).0013

蔡甫昌(Daniel Fu-Chang Tsai)；胡嘉輝(Kar-Fai Foo)

傳染病大流行 ； 資源分配 ； 重症醫療 ； 加拿大 ； 倫理 ； pandemic ； resource allocation ； critical care ； Canada ； ethics

台灣醫學

28卷5期（2024 / 09 / 25）

601 - 606

繁體中文;英文

本文介紹加拿大安大略省在面對COVID-19前兩波疫情（2020-2022年）時，提出醫療資源分配指引的歷程與內涵，其建立在數十年生命倫理專業之培養、主導公共議題審議、鼓勵公民參與、建議國家政策制定方向…等經驗，都十分值得參考。此次指引之建立，加拿大政府也面臨程序正義之挑戰，包括如何確保利害關係人的充分參與，及分配指引是否應向一般大眾公開等。本文建議主管機關在擬定分配指引時，應尋求眾多利害關係人之參與，並確保決策過程之透明度。

This article presents the process and contents of the ethical guidelines for the allocation of medical resources proposed by Ontario, Canada, in response to the first two waves of the COVID-19 pandemic in 2020-2022. These guidelines are founded upon decades of cultivation in the field of bioethics, leadership in public issue deliberation, encouragement of citizen participation, and recommendations for national policy-all of which are commendable experiences. The establishment of these guidelines also posed challenges of procedural justice for the Canadian government, including ensuring the full participation of stakeholders and whether the allocation guidelines should be made public. We suggest that the competent authorities, when drafting allocation guidelines, should seek the participation of numerous stakeholders of different interests and ensure the transparency of the decision-making process.