大量傷患醫療資源分配之倫理思辨－以八仙塵爆為例

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。

關鍵字

大量傷患；醫療資源；倫理；燒傷

並列摘要

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.

並列關鍵字

mass casualty incident ； medical resources ； ethical ； burn

參考文獻

王宗倫、石富元、陳輝財（2005）．災難醫學精要．新北市：金名圖書。[Wang, T. L., Hsih, F. Y., & Chen, H. T. (2005). Essentials of disaster medicine. New Taipei City, Taiwan, ROC: Kingdom.]

徐明儀、江蓮瑩（2014）．無效醫療議題之探討．護理雜誌，61（1），99–104。[Hsu, M. Y., & Chiang, L. Y. (2014). Exploring medical futility. The Journal of Nursing, 61(1), 99–104.] doi:10.6224/JN.61.1.99

蘇騰葳、周大為、方震中、蔡甫昌（2015）．粉塵爆炸事件之緊急醫療倫理問題探討．台灣醫學，19（5），508–516。[Su, T. W., Jou, D. W., Fang, C. C., & Tsai, D. F. C. (2015). The ethical issues of medical emergency in the color dust explosion events. Formosan Journal of Medicine, 19(5), 508–516.] doi:10.6320/FJM.2015.19(5).09

De Boer, J. (1990). Definition and classification of disaster: Introduction of a disaster severity scale. The Journal of Emergency Medicine, 8(5), 591–595. doi:10.1016/0736-4679(90)90456-6

Edwards, S. D. (2009). Nursing ethics: A principle-based approach (2nd ed.). London, UK: Palgrave Macmillan.

國際替代計量

大量傷患醫療資源分配之倫理思辨－以八仙塵爆為例

全文下載

主題瀏覽