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专业精神在我们这个时代的大流行病中受到了重新审视:COVID-19 和种族主义。

Professionalism revisited during the pandemics of our time: COVID-19 and racism.

机构信息

Department of Medicine, University of Florida College of Medicine, 32610, Gainesville, FL, USA.

Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Canada.

出版信息

Perspect Med Educ. 2021 Aug;10(4):238-244. doi: 10.1007/s40037-021-00657-w. Epub 2021 Mar 18.

Abstract

In this article the authors review the current-day definition of professionalism through the lens of the two ongoing pandemics: COVID-19 and racism. The pandemics have led to contemporary practice-related questions, such as: does professionalism entail that health care providers (HCP) be compelled to treat patients without PPE or if patients refuse to wear masks? And what role do HCP play in society when confronted with glaring health disparities and police brutality? The authors propose using care ethics as a theory to view professionalism, as it takes into account broadly encompassing relationships between HCP and society, history and context. Professionalism viewed through a care ethics lens would require professionalism definitions to be expanded to allow for interventions, i.e., not just refrain from doing harm but actively interfere or take action if wrong is being witnessed. Principles related to the primacy of patient welfare need to be re-addressed to prevent systematic self-sacrifice which results in harm to HCP and burnout. Mature care should be a characteristic of professionalism ensuring that HCP care for the sick but be practically wise, highlighting the importance of balancing too little and too much care for self and others. Professionalism needs to be viewed as a bi-directional relational exchange, with society demonstrating solidarity with those providing care. Additionally, given the scale of health disparities, simply stating that HCP need to work towards social justice oversimplifies the problem. Professionalism needs to encompass incorporating critical action and critical pedagogy into health care training and the health care profession to demonstrate solidarity with those impacted by racism.

摘要

本文通过正在发生的 COVID-19 大流行和种族主义这两大流行病的视角来审视当今的专业精神定义。这两场大流行引发了与当代实践相关的问题,例如:专业精神是否要求医疗保健提供者(HCP)在没有个人防护设备的情况下被迫治疗患者,或者如果患者拒绝戴口罩?当面对明显的健康差距和警察暴行时,HCP 在社会中扮演什么角色?作者提出使用关怀伦理作为一种理论来审视专业精神,因为它考虑到了 HCP 与社会、历史和背景之间广泛的涵盖关系。从关怀伦理视角来看待的专业精神将要求扩大专业精神的定义,以允许进行干预,即不仅要避免伤害,还要在目睹错误时积极干预或采取行动。需要重新考虑与患者福利至上相关的原则,以防止系统的自我牺牲导致对 HCP 的伤害和倦怠。成熟的关怀应该是专业精神的一个特征,确保 HCP 关怀病人,但要明智实际,强调在自我和他人之间平衡过少和过多关怀的重要性。专业精神需要被视为一种双向的关系交换,社会要向提供关怀的人展示团结。此外,鉴于健康差距的规模,仅仅说 HCP 需要努力实现社会正义就过于简化了这个问题。专业精神需要将批判行动和批判教育学纳入医疗保健培训和医疗保健专业,以展示与受种族主义影响的人团结一致。

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