Kubheka-Chauke Brenda Z
Harvard Medical School, Center for Bioethics, Harvard University, Boston, United States of America.
Department of Clinical Risk and Ethics, Health IQ Consulting, Johannesburg, South Africa.
J Coll Med S Afr. 2024 Oct 24;2(1):80. doi: 10.4102/jcmsa.v2i1.80. eCollection 2024.
Diversity, inclusion, equity and access (DIEA) are fundamental principles deeply intertwined with South Africa's historical narrative. Despite strides towards equality, the medical profession remains susceptible to challenges related to DIEA like the rest of society. Issues such as racial and gender bias, alongside covert discriminatory practices, persist within medical institutions. These concerns underscore the imperative for the medical community to prioritise diversity, inclusion and equitable access to opportunities throughout training and professional practice.
This review aims to assess the current status of DIEA in South Africa, identify research and practice gaps and position South Africa within the global discourse on DIEA in medicine.
Worldwide literature review was conducted to set a foundation for the analysis of the SA medical profession.
A review of global literature was conducted to explore themes related to diversity, inclusion, access and equity in medicine.
Existing literature lacks sufficient focus on DIEA in the South African context, but highlights more United States-based discourse. There are limited empirical studies exploring systemic DIEA practices and its impact on access to opportunities and how it affects the well-being of underrepresented groups in medicine. These findings underscore the critical need for inclusive practices to drive both individuals and institutions to create a safe and just culture in medicine.
Prioritising implementation and monitoring of inclusive policies and practices within the medical profession is imperative and should aim beyond numerical representation. Progress will be achieved through collaboration with bioethicists.
Providing insights and recommendations to advance DIEA in the South African field of medicine contributes to creating a more equitable and just medical profession.
多元化、包容性、公平性与机会均等（DIEA）是与南非历史叙事紧密交织的基本原则。尽管在平等方面取得了进展，但医学界与社会其他领域一样，仍然容易受到与DIEA相关的挑战。种族和性别偏见等问题，以及隐蔽的歧视性做法，在医疗机构中依然存在。这些问题凸显了医学界在整个培训和专业实践过程中优先考虑多元化、包容性以及公平获取机会的紧迫性。
本综述旨在评估南非DIEA的现状，识别研究与实践差距，并将南非置于全球医学领域DIEA话语体系之中。
进行了全球范围的文献综述，为分析南非医学界奠定基础。
对全球文献进行综述，以探索医学领域中与多元化、包容性、机会均等和公平性相关的主题。
现有文献对南非背景下的DIEA关注不足，更多地强调了基于美国的论述。探索系统性DIEA实践及其对获取机会的影响以及它如何影响医学领域中代表性不足群体福祉的实证研究有限。这些发现凸显了采用包容性实践以推动个人和机构在医学领域营造安全公正文化的迫切需求。
当务之急是在医学界优先实施和监测包容性政策与实践，其目标不应局限于数字上的代表性。通过与生物伦理学家合作将取得进展。
提供见解和建议以推动南非医学领域的DIEA，有助于打造一个更加公平公正的医学界。
