University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore, Maryland, 21230, USA.
Virgina Commonwealth University, 1101 E. Leigh Street, P.O. Box 980566, Richmond, Virginia, 23298-0566, USA.
Community Dent Oral Epidemiol. 2023 Aug;51(4):609-614. doi: 10.1111/cdoe.12854. Epub 2023 Mar 26.
We re-envision dentistry's social contract and elaborate on the idea that it is not neutral and free from such things as racism and white supremacy and can act as a tool of oppression.
We critique social contract theory through examination of classical and contemporary contract theorists. More specifically, our analysis draws from the work of Charles W. Mills, a philosopher of race and liberalism, as well as the theoretical and praxis framework of intersectionality.
Social contract theory supports hierarchies and inequities that may be used to sustain unfair and unjust differences in oral health between social groups. When dentistry's social contract becomes a tool of oppression, its practice does not promote health equity but reinforces damaging social norms.
Dentistry must embrace an anti-oppression framing of equity and elevate the principle of justice to one of liberation and not just fairness. In doing so, the profession can better understand itself, act more equitably and empower practitioners to advocate for justice in health and healthcare in its fullest sense. Anti-oppressive justice supports health not as merely an obligation but as a human duty.
我们重新构想牙科的社会契约，并详细阐述这样一个观点，即它并非中立的，也不能免受种族主义和白人至上主义等因素的影响，它可以成为压迫的工具。
我们通过考察古典和当代契约理论家来批判社会契约理论。更具体地说，我们的分析借鉴了哲学家查尔斯·W·米尔斯（Charles W. Mills）的著作，以及交叉性理论和实践框架。
社会契约理论支持可能被用来维持社会群体之间在口腔健康方面不公平和不公正差异的等级制度和不平等。当牙科的社会契约成为压迫的工具时，它的实践并不能促进健康公平，而是强化了破坏性的社会规范。
牙科必须采用公平的反压迫框架，并将正义原则提升为解放而不仅仅是公平的原则。这样，该专业才能更好地理解自己，更公平地行事，并赋予从业者在健康和医疗保健方面以正义的力量。反压迫正义将健康不仅视为一种义务，而且视为一种人类责任。
