{"title":"健康结构性驱动因素的创伤知情筛查。","authors":"Elizabeth Lanphier, James Duffee","doi":"10.1001/amajethics.2025.678","DOIUrl":null,"url":null,"abstract":"<p><p>Screening for structural drivers or determinants of health (SDoH), as mandated by recent federal regulations, raises ethical questions about screening processes and tools. Early childhood adversity and trauma, which can influence a person's health throughout their lifespan and contribute to chronic disease and early death, can be identified through standardized screening for SDoH. However, screening without awareness of the potential interface between SDoH and trauma can retraumatize those administering or completing the screening process. This article suggests that implementation of a trauma-informed approach to SDoH screening is consistent with biomedical and public health ethics and contributes to efforts to keep clinical environments emotionally safe.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 9","pages":"E678-685"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trauma-Informed Screening for Structural Drivers of Health.\",\"authors\":\"Elizabeth Lanphier, James Duffee\",\"doi\":\"10.1001/amajethics.2025.678\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Screening for structural drivers or determinants of health (SDoH), as mandated by recent federal regulations, raises ethical questions about screening processes and tools. Early childhood adversity and trauma, which can influence a person's health throughout their lifespan and contribute to chronic disease and early death, can be identified through standardized screening for SDoH. However, screening without awareness of the potential interface between SDoH and trauma can retraumatize those administering or completing the screening process. This article suggests that implementation of a trauma-informed approach to SDoH screening is consistent with biomedical and public health ethics and contributes to efforts to keep clinical environments emotionally safe.</p>\",\"PeriodicalId\":38034,\"journal\":{\"name\":\"AMA journal of ethics\",\"volume\":\"27 9\",\"pages\":\"E678-685\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AMA journal of ethics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1001/amajethics.2025.678\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Social Sciences\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AMA journal of ethics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1001/amajethics.2025.678","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Social Sciences","Score":null,"Total":0}
Trauma-Informed Screening for Structural Drivers of Health.
Screening for structural drivers or determinants of health (SDoH), as mandated by recent federal regulations, raises ethical questions about screening processes and tools. Early childhood adversity and trauma, which can influence a person's health throughout their lifespan and contribute to chronic disease and early death, can be identified through standardized screening for SDoH. However, screening without awareness of the potential interface between SDoH and trauma can retraumatize those administering or completing the screening process. This article suggests that implementation of a trauma-informed approach to SDoH screening is consistent with biomedical and public health ethics and contributes to efforts to keep clinical environments emotionally safe.
期刊介绍:
The AMA Journal of Ethics exists to help medical students, physicians and all health care professionals navigate ethical decisions in service to patients and society. The journal publishes cases and expert commentary, medical education articles, policy discussions, peer-reviewed articles for journal-based and audio CME, visuals, and more. Since its inception as an editorially-independent journal, we promote ethics inquiry as a public good.