Health Inequality as a Socially Created Complex System

Abstract

Brought to light by COVID-19, and the Black Lives Matter and Twitter #BlackBioethics movements, bioethics as a discipline has not intentionally accounted for distributive justice in its scholarship. Modern society exhibits gross disparities that affect marginalized populations who suffer amid social, financial, physical and emotional stressors. While marginalized groups that are underserved are not monoliths, disparity persists in disadvantaged communities regardless of social and economic strata. Disparity is the epitome of injustice. The overemphasis on proximal determinants demonstrates ill placed overemphasis on personal culpability whilst ignoring systemic factors that result in structural injustice. The sciences of complexity and systems thinking move healthcare beyond historically ingrained heuristics that more often than not entrench disparities meant to be reversed. This paper sets out the argument that the application of complexity and systems as a groundwork for culturally inclusive bioethics by framing health disparities as structurally and morally complex.