Tucker Edmonds Brownsyne, Schmidt Alison, Walker Valencia P
Associate Professor of Obstetrics and Gynecology & Vice Chair for Faculty Development and Diversity, Department of Obstetrics and Gynecology; Assistant Dean for Diversity Affairs, Indiana University School of Medicine, Indianapolis, IN.
Indiana University School of Medicine, Indianapolis, IN.
Semin Perinatol. 2022 Apr;46(3):151524. doi: 10.1016/j.semperi.2021.151524. Epub 2021 Nov 9.
Addressing bias and disparities in counseling and care requires that we contend with dehumanizing attitudes, stereotypes, and beliefs that our society and profession holds towards people of color, broadly, and Black birthing people in particular. It also necessitates an accounting of the historically informed, racist ideologies that shape present-day implicit biases. These biases operate in a distinctly complex and damaging manner in the context of end-of-life care, which centers around questions related to human pain, suffering, and value. Therefore, this paper aims to trace biases and disparities that operate in periviable care, where end-of-life decisions are made at the very beginning of life. We start from a historical context to situate racist ideologies into present day stereotypes and tropes that dehumanize and disadvantage Black birthing people and Black neonates in perinatal care. Here, we review the literature, address historical incidents and consider their impact on our ability to deliver patient-centered periviable care.
解决咨询和护理中的偏见及差异问题，要求我们应对我们的社会和职业对有色人种，尤其是对黑人分娩者所持的非人性化态度、刻板印象和信念。这也需要考量那些形成当今隐性偏见的、有历史根源的种族主义意识形态。在围绕人类疼痛、苦难和价值等问题的临终护理背景下，这些偏见以一种极其复杂且有害的方式发挥作用。因此，本文旨在追溯在可存活期护理中存在的偏见和差异，在这种护理中，临终决定在生命伊始就已做出。我们从历史背景入手，将种族主义意识形态置于当今的刻板印象和比喻之中，这些刻板印象和比喻在围产期护理中使黑人分娩者和黑人新生儿失去人性并处于不利地位。在此，我们回顾文献，探讨历史事件，并考虑它们对我们提供以患者为中心的可存活期护理能力的影响。
