University of Brighton, Falmer, East Sussex, UK.
Nurs Inq. 2010 Sep;17(3):248-56. doi: 10.1111/j.1440-1800.2010.00494.x.
Growing concerns over undignified health-care has meant the concept of dignity is currently much discussed in the British National Health Service. This has led to a number of policies attempting to reinstate dignity as a core ethical value governing nursing practice and health-care provision. Yet these initiatives continue to draw upon a concept of dignity which remains reliant upon a depoliticised, ahistorical and decontexualised subject. In this paper, we argue the need to revise the dignity debate through the lens of feminism and theories of recognition. Postmodern feminist theories provide major challenges to what remain dominant liberal approaches as they pay attention to the contingent, reflexive, and affective aspects of care work. Theories of recognition provide a further critical resource for understanding how moral obligations and responsibilities towards others and our public and private responses to difference arise. This re-situates dignity as a highly contested and politicised concept involving complex moral deliberations and diverse political claims of recognition. The dignity debate is thus moved beyond simplistic rational injunctions to care, or to care more, and towards critical discussions of complex politicised, moral practices infused with power that involve the recognition of difference in health-care.
人们对不体面的医疗保健越来越担忧,这意味着尊严的概念目前在英国国民保健制度中被广泛讨论。这导致了许多试图将尊严重新作为规范护理实践和医疗保健提供的核心伦理价值观的政策。然而,这些举措仍然依赖于一种尊严概念,这种概念仍然依赖于去政治化、非历史化和去语境化的主体。在本文中,我们认为需要通过女性主义和承认理论的视角来修正尊严的辩论。后现代女性主义理论对仍然占主导地位的自由派方法提出了重大挑战,因为它们关注护理工作的偶然性、反思性和情感方面。承认理论为理解我们对他人的道德义务和责任以及我们对差异的公共和私人反应是如何产生的提供了进一步的批判性资源。这将尊严重新定位为一个高度有争议和政治化的概念,涉及复杂的道德思考和对承认的多样化政治主张。因此,尊严的辩论不再仅仅是简单的理性关怀或更多的关怀,而是转向对充满权力的复杂政治化、道德实践的批判性讨论,这些实践涉及医疗保健中对差异的承认。