Abstract
BackgroundSocial and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities.ResultsSome see doctors as bound by a notion of care that is blind to a patient's social position, while others respond to this issue through invoking notions of justice and human rights where access to care is a prime focus. Both care and justice orientations however conceal important tensions linked to the presence of bioethical principles underpinning these. Other normative ethical theories like deontology, virtue ethics and utilitarianism do not provide adequate guidance on the problem of social health inequities either.ConclusionThis paper explores if Bauman's notion of "forms of togetherness" provides the basis of a relational ethical theory that can help to develop a response to social health inequities of relevance to individual physicians. This theory goes beyond silence on the influence of social position of health and avoids amoral regulatory approaches to monitoring equity of care provision.
Highlights
Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do
The family physician cannot avoid the effects of social disadvantage in their ongoing relationship with their patients
How to respond to these inequities is challenging and there is a lack of adequate ethical guidance on the matter
Summary
Two moral orientations and the survival of bioethical principles The initial study results [15] found critical differences in the values that different groups expressed on social health inequities and physician responsibility. While it may be said that recognising our differences still does not address the issue of responding directly to inequities, a change such as that outlined by Forester and Heck in how we respond to the issue of social health inequities has moral consequences This ontological shift makes inequities and differences a part of our relationships, and the example we have provided relates to the particular case of the insured in the U.S, there are patients who have financial difficulties in accessing various parts of the health service in all health care systems. Developing the relation of being-for is possible within the day to day primary care medical encounter This need not be overwhelming for clinicians, faced with a full waiting room of patients and the responsibility and seeming impossibility of acting on the social and societal forces embodied in each. This paper was developed through successive drafts, iterations and meetings between both JF and VP, who contributed to the final manuscript
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
