当结构性不平等无处不在时，武力能有一丝怜悯吗？

When Structural Inequity Is Ubiquitous, Can Force Ever Be Compassionate?

机构信息

Postdoctoral research fellow in health disparities and multicultural mental health with a dual affiliation at the Health Equity Research Lab at Harvard Medical School in Cambridge, Massachusetts, and the PRIME Center for Health Equity at Albert Einstein College of Medicine/Montefiore Medical Center in New York City.

Assistant professor with a dual affiliation at the PRIME Center for Health Equity at Albert Einstein College of Medicine/Montefiore Medical Center in New York City and the Health Equity Research Lab at Harvard Medical School in Cambridge, Massachusetts.

出版信息

AMA J Ethics. 2021 Apr 1;23(4):E340-348. doi: 10.1001/amajethics.2021.340.

DOI:10.1001/amajethics.2021.340

PMID:33950830

Abstract

This article contextualizes and challenges race, class, and gender inequity in psychiatric use of force. In particular, this article examines (1) how uses of force-seclusion, restraint, compulsion-have been codified in policy and law, (2) inequity in force utilization, and (3) connections between systemic oppression and individuals' responses-including fear and retraumatization-to feeling threatened by force in clinical settings. This article proposes multilevel strategies to abolish inequity in uses of force in clinical settings and questions whether it is ever possible to use force compassionately where inequity persists.

摘要

本文从种族、阶级和性别角度来探讨精神科使用武力的问题。具体来说，本文考察了（1）武力的使用——隔离、约束、强制——在政策和法律中的规定，（2）武力使用的不平等，以及（3）系统压迫与个体在临床环境中对武力威胁的反应之间的联系，包括恐惧和再创伤。本文提出了在临床环境中消除武力使用不平等的多层次策略，并质疑在不平等持续存在的情况下，是否有可能以同情的方式使用武力。