台灣政府的倫理責任與義務：談COVID-19防疫的醫療口罩分配

Taiwanese Government of Ethical Responsibilities and Obligations: Distribution of Medical Masks for COVID-19 Prevention

2020年初COVID-19席捲全世界，台灣也受到衝擊，由於醫學實證顯示，醫療口罩能抵擋含病毒的飛沫，具保護力，但台灣當下醫療口罩不足，而政府有義務與責任守護民眾的健康，如何針對有限的資源進行有效的分配，並考量相關的優先權，需有倫理的理據作支持，才能使決策正當化。政府以維護國家社會安全為第一，因此將醫療口罩列為防疫物資，並制定防疫物資管制出口政策，限制口罩出口，為了維持醫療量能，第一線的醫護人員與防疫人員具領取醫療口罩的優先權，其他的人則依實名制購買醫療口罩，讓人人都有醫療口罩使用以做防護，使罹病率降至最低，以達到功利主義所言「道德行動的目標在於使所有的人的總體幸福最大化」，讓民眾能安居樂業。在醫療口罩產能日趨穩定，則開放出口甚至致贈友邦，展現悲天憫人與仁愛精神。政府對有限的醫療口罩的分配以及相關政策的宣導實施，起源於公平正義的倫理決策，其相關措施可做為日後面臨類似公共衛生情境時之參考依據，以維護大眾健康。

Coronavirus Disease 2019 has devastated Taiwan and the world since the early 2020. Medical evidence has confirmed the effectiveness of medical masks in protecting people from virus-containing respiratory droplets. However, because the number of medical masks in Taiwan was insufficient by then, the Taiwanese government, the protector of its public health, had to effectively distribute these limited resources to the people in need. The order in which these resources were distributed needed ethical reasons as the support to justify the decisions made. With national and social security being a top priority, the Taiwanese government classified medical masks as epidemic-prevention materials and formulated epidemic-prevention material export-related control policies to restrict the export of medical masks. Additionally, to ensure that medical institutions operate in full capacity, frontline medical staff and epidemic-prevention personnel have top priority in obtaining medical masks. For the rest of the public,“Name-based Mask Distribution System”are required when they purchase medical masks. These measures enable everyone to wear medical masks, protecting themselves from the virus, minimizing the rates of them contracting the virus, allowing them to live and work in peace and contentment, and achieving the utilitarian goal of“taking moral actions that maximize the overall wellbeing of everyone.”With Taiwan’s medical mask production capacity now sufficient, medical masks are being exported and even donated to ally countries, demonstrating Taiwan’s merciful spirit. The Taiwanese government’s distribution of limited resources (i.e., medical masks) as well as its advocacy and implementation of relevant policies are based on justice and ethical decisions. Such a practice may serve as a reference to relevant units when encountering similar situations in the future in order to protect public health.