Tembo Agness C
THE UNIVERSITY OF SYDNEY, Susan Wakil School of Nursing and Midwifery | Sydney Nursing School. Faculty of Medicine and Health, Level 8 East, Susan Wakil Health Building, The University of Sydney, Sydney, NSW, Australia.
Nurs Philos. 2025 Oct;26(4):e70038. doi: 10.1111/nup.70038.
Amid rising awareness of both overt and covert racism and the persistence of epistemic injustice within healthcare systems, there is an urgent need to revisit foundational ethical concepts in nursing. This article offers a critical and respectful engagement with Megan-Jane Johnstone's (2011) conceptualisation of justice as a basic human need grounded in a distributive framework. While her work significantly advanced justice as a moral imperative in nursing, it reflects an individualistic and deontological orientation that can insufficiently address the relational, embodied, and structural dimensions of injustice experienced by racialised patients and practitioners. Drawing on contemporary phenomenological philosophy, relational ethics, and post-pandemic scholarship, I advance an alternative view of justice as a dynamic, intersubjective, and contextually situated practice. Engaging with thinkers such as Merleau-Ponty, Carel, Fricker, and proponents of Ubuntu ethics, this article argues for a shift from distributive to relational justice, one that centres mutual recognition, epistemic humility, and ethical responsiveness. Such a reconceptualisation offers a more inclusive and situated ethical framework, capable of responding to the moral complexities and inequities shaping contemporary nursing practice.
在人们对公开和隐蔽的种族主义的认识不断提高,以及医疗保健系统中认知不公正持续存在的背景下,迫切需要重新审视护理中的基本伦理概念。本文对梅根 - 简·约翰斯通(2011年)将正义概念化为基于分配框架的基本人类需求的观点进行了批判性且尊重的探讨。虽然她的工作极大地推动了正义成为护理中的一项道德要求,但它反映了一种个人主义和道义论的取向,这种取向可能无法充分解决种族化患者和从业者所经历的不公正的关系、身体和结构层面的问题。借鉴当代现象学哲学、关系伦理学和疫情后学术研究,我提出了一种将正义视为动态、主体间且情境化实践的替代观点。通过与诸如梅洛 - 庞蒂、卡雷尔、弗里克等思想家以及乌班图伦理学的支持者进行探讨,本文主张从分配正义转向关系正义,这种转变以相互承认、认知谦逊和道德回应为核心。这样的重新概念化提供了一个更具包容性和情境性的伦理框架,能够应对塑造当代护理实践的道德复杂性和不平等问题。