During pandemics, the ethicists, public health professionals, and human rights advocates raise a red flag about different public health actions that should, at best, be addressed through integrated, global policies. How to rationalize the healthcare resources and prioritize the cases is not a recent challenge but the serious concern about that is how to achieve this while not increasing the vulnerability of the disadvantaged population. Health Care professionals use different scoring systems as a part of their decision-making so the medical teams and triage committees can allocate resources for predictable health outcomes and prognosis as well as to appropriately triage the patients accordingly. However, the value of existing scoring systems to manage COVID-19 cases is not well-established yet. Part of this problem includes managing non-COVID patients with chronic medical conditions like non-communicable diseases and addressing their medical needs during the pandemic complex context in a way to avoid worsening their conditions and, on the other hand, avoid hindering the establishment of comprehensive standards for dealing with COVID-19. In this article, we discuss this dilemma as well as how preexisting ethical standards were challenged by COVID-19, We also discuss how monitoring the consistent application of ethical standards during the medical trials of new medications, vaccines or unproven medical interventions is also a critical issue. Conclusion: comprehensive, transparent, and culturally acceptable policies and procedures corresponding to pandemics should be developed globally regarding patient triage, efficient rationing of limited healthcare resources based on clearly defined measures while avoiding disproportionate impacts on vulnerable populations and considering health workers at high risk. Moreover, any such policies should consider bioethical measures for unproven or experimental interventions.

中文翻译：

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公共卫生行动和政策的道德维度，特别关注 COVID-19

在大流行期间，伦理学家、公共卫生专业人员和人权倡导者对不同的公共卫生行动提出了危险信号，这些行动充其量应该通过综合的全球政策来解决。如何合理化医疗资源并优先处理病例并不是最近的挑战，但令人严重关切的是如何在不增加弱势群体脆弱性的情况下实现这一目标。医疗保健专业人员使用不同的评分系统作为决策的一部分，以便医疗团队和分诊委员会可以为可预测的健康结果和预后分配资源，并相应地对患者进行适当的分诊。然而，现有评分系统在管理 COVID-19 病例方面的价值尚未明确。这一问题的一部分包括管理患有非传染性疾病等慢性病的非新冠患者，并在大流行复杂的背景下满足他们的医疗需求，以避免病情恶化，另一方面，避免阻碍建立全面的医疗服务体系。处理 COVID-19 的标准。在本文中，我们讨论了这一困境，以及先前存在的道德标准如何受到 COVID-19 的挑战，我们还讨论了在新药物、疫苗或未经证实的医疗干预措施的医学试验期间监控道德标准的一致应用如何也是至关重要的问题。结论：应在全球范围内制定针对流行病的全面、透明和文化上可接受的政策和程序，包括患者分诊、基于明确定义的措施有效配给有限的医疗资源，同时避免对弱势群体造成不成比例的影响，并考虑处于高风险的卫生工作者。此外，任何此类政策都应考虑针对未经证实或实验性干预措施的生物伦理措施。