«Doctors must live»: a care ethics inquiry into physicians' late modern suffering.

IF 2.3 2区 哲学 Q1 ETHICS
Caroline Engen
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Abstract

In 2023, thousands of young Norwegian physicians joined an online movement called #legermåleve (#doctorsmustlive) and shared stories of their own mental and somatic health issues, which they considered to be caused by unacceptable working conditions. This paper discusses this case as an extreme example of physicians' and healthcare workers' suffering in late modern societies, using Vosman and Niemeijer's approach of rethinking care imaginaries by a structured process of thinking along, counter-thinking and rethinking, bringing to bear suffering as a heuristic device. Thinking along, taking the physicians' stories and arguments literally, reveals an image of an unbearable workload. Counter-thinking resituates their suffering within the broader conditions of late modernity, suggesting that the root cause may lie not in the quantity of the workload itself but in its qualities and in its perceived threat to their integrity as caregivers through epistemic and moral injury and an inability to respond to this threat. In rethinking, the ambiguity of suffering- its dual potential as both a constraint and an opening- becomes central. Following the physicians' own interpretations and the solutions emerging from this framing, both their suffering and that of their patients could paradoxically be exacerbated by further decentering physicians and reinforcing utilitarian, data-driven approaches. However, staying with their suffering and reinterpreting its causes opens possibilities to leverage critiques of medicalization at large and of their own suffering in particular, challenging the assumption that the weight of care must always grow heavier. From this reframing, I argue, it is possible to reclaim and reimagine care and the clinical space as a nexus of epistemic and moral privilege, recentering response-ability both relationally and socially.

"医生必须活下去":对医生晚期现代痛苦的护理伦理探究。
2023年,数千名年轻的挪威医生加入了一个名为# legerm level (#doctorsmustlive)的在线运动,并分享了他们自己的精神和身体健康问题的故事,他们认为这些问题是由不可接受的工作条件造成的。本文将这一案例作为医生和医疗工作者在现代社会后期遭受痛苦的一个极端例子进行讨论,使用沃斯曼和尼迈耶的方法,通过一个结构化的思考过程来重新思考护理想象,反思考和再思考,将痛苦作为一种启发式装置。仔细想想,从字面上理解医生的故事和论点,揭示了一个难以忍受的工作量的形象。反思考将他们的痛苦置于晚期现代性的更广泛的条件下,表明根本原因可能不在于工作量本身的数量,而在于工作量的质量,以及通过认知和道德伤害以及无法应对这种威胁而感知到的对他们作为照顾者的完整性的威胁。在重新思考中,痛苦的模糊性——它既是约束又是开放的双重潜力——成为中心。按照医生自己的解释和从这个框架中产生的解决方案,医生进一步去中心化和强化功利主义、数据驱动的方法,可能会矛盾地加剧他们和病人的痛苦。然而,关注他们的痛苦并重新解释其原因,为利用对医疗化的批评,特别是对他们自己的痛苦的批评提供了可能性,挑战了护理的重量总是越来越重的假设。我认为,从这种重构中,有可能将护理和临床空间作为认知和道德特权的纽带,重新进入关系和社会的反应能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.30
自引率
4.80%
发文量
64
期刊介绍: Medicine, Health Care and Philosophy: A European Journal is the official journal of the European Society for Philosophy of Medicine and Health Care. It provides a forum for international exchange of research data, theories, reports and opinions in bioethics and philosophy of medicine. The journal promotes interdisciplinary studies, and stimulates philosophical analysis centered on a common object of reflection: health care, the human effort to deal with disease, illness, death as well as health, well-being and life. Particular attention is paid to developing contributions from all European countries, and to making accessible scientific work and reports on the practice of health care ethics, from all nations, cultures and language areas in Europe.
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