著者

岡本 天晴 櫻庭 和典

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.15, pp.72-84, 1997-09-20 (Released:2018-02-01)

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The massive earthquake that hit the Hanshin region in January 1995 caused 6425 deaths and over 40,000 casualties. Major public utilities were cut off, so medical practitioners found medical activities extremely difficult. Rescue operations by the self-defence forces failed to function properly. This disaster has called attention to the importance of Triage regarding medical services in such large-scale disasters. Triage comes from French, and was brought into English during the First World War, and was used in classifying the wounded. The definitions of Triage are 1. Classifying the injured by the seriousness of their external injuries or illness. 2. Deciding on the order of superiority for treatment. Let us consider the ethics of Triage from the following two aspects. a. The Means : In times of crises such as a war or a large-scale disaster,traditional medical ethics do not apply. Limited medical resources will mean that a capable Triage Officer should independently and speedily sort (i.e. triage) patients based on high-quality initial diagnosis, and decide on the order in which they will be treated. The ethics will be based upon the fact that Triage is the means for attaining the maximum happiness for the maximum number of people. The appropriatenss of the means will be subject to change depending upon the situation. Therefore Triage is a process modified repeatedly. b. Education : For an inexperienced doctor, it is an ethically difficult mission to classify numerous patients in a way that is different from daily practice. There are also doctors who emphasize that practice drills for medical services in times of large-scale disasters is aiding and abetting war, and that classifying numerous patients is inhumane. Doctors know little about Trige, and the general public is uninterested, so once a disaster strikes there is major chaos. It is therefore desirable to train capable Triage leaders and at the same time have the man on the street undergo training to be ready for large-scale disasters, and have an understanding of Triage. By doing this, disaster survivors will be aware that there are many patients around them whose treatment requires priority, and they will be able to engage themselves in volunteer activities or await their turn for treatment whih understanding. In this manner, it is possible to acknowledge the high ethics of Triage in neighbourly love, or regional unity, which is needed in times of large-scale disasters.