Department of Anesthesia, Faculty of Health Sciences, McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada.
Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
Can J Anaesth. 2023 Jun;70(6):1026-1034. doi: 10.1007/s12630-023-02459-6. Epub 2023 Jun 2.
Microaggressions are subtle verbal or nonverbal insults that convey derogatory and negative messages to and about people who belong to oppressed groups. Microaggressions reflect structurally and historically perpetuated societal values, which advantage some groups of people by considering them to be inherently more worthy than others, while simultaneously disadvantaging others. While microaggressions may seem innocuous and are often unintentional, they cause tangible harm. Microaggressions are commonly experienced by physicians and learners working in perioperative and critical care contexts and are often not adequately addressed, for a multitude of reasons, including witnesses not knowing how to respond. In this narrative review, we provide examples of microaggressions towards physicians and learners working in anesthesia and critical care, and offer individual and institutional approaches to managing such incidents. Concepts of privilege and power are introduced to ground interpersonal interventions within the larger context of systemic discrimination, and to encourage anesthesia and critical care physicians to contribute to systemic solutions.
微侵犯是指微妙的言语或非言语侮辱，向属于受压迫群体的人和针对他们传达贬损和负面信息。微侵犯反映了结构上和历史上长期存在的社会价值观，这些价值观通过认为某些群体天生比其他群体更有价值，从而使一些群体受益，同时使其他群体处于不利地位。虽然微侵犯看起来似乎无害，而且往往是无意的，但它们会造成切实的伤害。在围手术期和重症监护环境中工作的医生和学习者经常会经历微侵犯，但由于多种原因，包括目击者不知道如何回应，这些微侵犯往往没有得到充分解决。在这篇叙述性评论中，我们提供了针对麻醉和重症监护领域的医生和学习者的微侵犯的例子，并提供了个人和机构管理此类事件的方法。特权和权力的概念被引入，以便将人际干预置于系统性歧视的更大背景下，并鼓励麻醉和重症监护医生为系统性解决方案做出贡献。
