ABSTRACT:

Clinical ethics consultants bear witness to the direct harms of intersecting axes of oppression—such as racism and classism—as they impinge on elucidating and resolving ethical dilemmas in health care. Health Care Ethics Consultation (HCEC) professional guidance supports recognizing and analyzing power dynamics and social-structural obstacles to good care. However, the most relied upon bioethical principles in clinical ethics have been criticized for insufficiency in this regard. While individual ethics consultants have found ways to expand their approaches, they do so in an ad hoc way without frameworks to guide consistency. Motivated by the practical expertise of clinical ethicists, this essay offers a new framework to support openness to analyzing power imbalances and respecting marginalized voices and values. This framework is grounded in transformative justice, where the aim is to take responsibility for oppression by centering and responding to moral perspectives and value systems that are all too often silenced.

摘要：

临床伦理顾问见证了交叉压迫轴的直接危害——例如种族主义和阶级歧视——因为它们影响到阐明和解决医疗保健中的伦理困境。医疗保健伦理咨询 (HCEC) 专业指南支持识别和分析权力动态和良好护理的社会结构障碍。然而，临床伦理学中最依赖的生物伦理学原则因在这方面的不足而受到批评。虽然个别道德顾问已经找到了扩展方法的方法，但他们是在没有框架来指导一致性的情况下以临时方式这样做的。在临床伦理学家的实践专业知识的推动下，本文提供了一个新的框架来支持开放性分析权力失衡和尊重边缘化的声音和价值观。