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哲学与临床:污名、尊重与羞耻

Philosophy and the clinic: Stigma, respect and shame.

机构信息

Institute for Person-Centred Health and Social Care, School of Biomedical Sciences, University of West London, London, UK.

Department of Sociology, Philosophy and Anthropology, University of Exeter, Exeter, UK.

出版信息

J Eval Clin Pract. 2022 Oct;28(5):705-710. doi: 10.1111/jep.13755. Epub 2022 Sep 2.

Abstract

Since its foundation in 2010, the annual philosophy thematic edition of this journal has been a forum for authors from a wide range of disciplines and backgrounds, enabling contributors to raise questions of an urgent and fundamental nature regarding the most pressing problems facing the delivery and organization of healthcare. Authors have successfully exposed and challenged underlying assumptions that framed professional and policy discourse in diverse areas, generating productive and insightful dialogue regarding the relationship between evidence, value, clinical research and practice. These lively debates continue in this thematic edition, which includes a special section on stigma, shame and respect in healthcare. Authors address the problems with identifying and overcoming stigma in the clinic, interactional, structural and phenomenological accounts of stigma and the 'stigma-shame nexus'. Papers examine the lived experience of discreditation, discrimination and degradation in a range of contexts, from the labour room to mental healthcare and the treatment of 'deviancy' and 'looked-after children'. Authors raise challenging questions about the development of our uses of language in the context of care, and the relationship between stigma, disrespect and important analyses of power asymmetry and epistemic injustice. The relationship between respect, autonomy and personhood is explored with reference to contributions from an important conference series, which includes analyses of shame in the context of medically unexplained illness, humour, humiliation and obstetric violence.

摘要

自 2010 年成立以来,该期刊的年度哲学专题版一直是来自广泛学科和背景的作者的论坛,使撰稿人能够提出有关医疗保健提供和组织所面临的最紧迫问题的紧急和根本性问题。作者成功地揭露和挑战了在不同领域构成专业和政策话语框架的基本假设,就证据、价值、临床研究和实践之间的关系生成了富有成效和富有洞察力的对话。这些激烈的辩论在本期特刊中继续进行,其中包括一个关于医疗保健中的耻辱、羞耻和尊重的特别部分。作者解决了在临床、互动、结构和现象学方面识别和克服耻辱感的问题,以及“耻辱-羞耻联系”。论文从劳动室到精神保健和对“偏差”和“受照顾儿童”的治疗,研究了在各种背景下名誉受损、歧视和退化的生活经历。作者提出了关于我们在护理背景下语言使用的发展以及耻辱、不尊重与权力不对称和知识不公正的重要分析之间关系的具有挑战性的问题。参考一个重要的会议系列,探讨了尊重、自主性和人格之间的关系,其中包括在医学无法解释的疾病、幽默、屈辱和产科暴力背景下的羞耻感分析。

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