Addressing the Practical Implications of Intersectionality in Clinical Medicine: Ethical, Embodied and Institutional Dimensions

Barned, Claudia; Lajoie, Corinne; Racine, Éric

doi:10.1080/15265161.2018.1557278

Cited by 12 publications

(13 citation statements)

References 8 publications

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“…Other health disciplines have advanced intersectionality research, including medicine, 66 nursing, 67 psychology, 68 and psychiatry and mental health 69,70 . This work provides important learning opportunities for oral health research.…”

Section: How Could Oral Health Research Benefit From Adopting An Intementioning

confidence: 99%

What is intersectionality and why is it important in oral health research?

Muirhead

Milner

Freeman

et al. 2020

Comm Dent Oral Epid

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This paper is the second of two reviews that seek to stimulate debate on new and neglected avenues in oral health research. The first commissioned narrative review, “Inclusion oral health: Advancing a theoretical framework for policy, research and practice”, published in February 2020, explored social exclusion, othering and intersectionality. In it, we argued that people who experience social exclusion face a “triple threat”: they are separated from mainstream society, stigmatized by the dental profession, and severed from wider health and social care systems because of the disconnection between oral health and general health. We proposed a definition of inclusion oral health and a theoretical framework to advance the policy, research and practice agenda. This second review delves further into the concept of intersectionality, arguing that individuals who are socially excluded experience multiple forms of discrimination, stigma and disadvantage that reflect intersecting social identities. We first provide a theoretical and historical overview of intersectionality, rooted in Black feminist ideologies in the United States. Our working definition of intersectionality, requiring the simultaneous appreciation of multiple social identities, an examination of power and inequality, and a recognition of changing social contexts, then sets the scene for examining existing applications of intersectionality in oral health research. A critique of the sparse application of intersectionality in oral health research highlights missed opportunities and shortcomings related to paradigmatic and epistemological differences, a lack of robust theoretically engaged quantitative and mixed methods research, and a failure to sufficiently consider power from an intersectionality perspective. The final section proposes a framework to guide future oral health research that embraces an intersectionality agenda consisting of descriptive research to deepen our understanding of intersectionality, and transformative research to tackle social injustice and inequities through participatory research and co‐production.

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Section: How Could Oral Health Research Benefit From Adopting An Intementioning

confidence: 99%

What is intersectionality and why is it important in oral health research?

Muirhead

Milner

Freeman

et al. 2020

Comm Dent Oral Epid

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“…However, Barned et al (2019) caution that quality care is not only an individual-level prerogative, and that quality care provision does not happen in a vacuum.…”

Section: Implications For Practicementioning

confidence: 99%

“…clinic, hospital) power/lack of power. Barned et al (2019) echo this argument, noting that more attention is needed around how clinical care reinscribes (lack of) power and the effects power has on healthcare practice and systems.…”

Section: Introductionmentioning

confidence: 99%

Neonatal intensive care nurses' accounts of care for mothers/families with substance‐exposed pregnancies: A critical discourse analysis

Welborn,

Nichols,

Gringle

et al. 2023

Journal of Advanced Nursing

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AimsTo explore the effects of power dynamics and hospital organizational structure upon neonatal intensive care nurses' experiences caring for infants and families from a substance‐exposed pregnancy (SEP).DesignThis secondary data analysis further investigated the results of a primary study after the original analysis suggested differences in work environments may impact relationship‐building opportunities between nurses and mothers/families. Critical discourse analysis served as both the theoretical lens and analytic technique.MethodNine (9) nurses from the southeast region of the United States (U.S.) were interviewed in 2019. Fifty‐one (51) stories of caregiving experiences were analysed with a focus on narratives related to organizational structure and care delivery.ResultsStudy findings revealed nurses experienced challenges providing high‐quality, family‐centered care for patients in the neonatal intensive care unit (NICU) affected by substances during pregnancy. Nurses described the central challenge of workload, exacerbated by power imbalances and structural constraints within the hospital's organizational structure. Findings suggest workload issues may endorse stigma by inhibiting opportunities to build relationships. Nurses report manageable workloads can support healthcare teams and recipients of care.ConclusionThe study suggests power imbalances between nurses, families and adjacent healthcare professionals can inhibit the delivery of high‐quality care. Supporting healthcare teams and recipients of care while centering the role of organizational structure is critical. Questions emerged about workload demands impacting the potential production of stigma in clinical environments.ImpactThis study examines the intersection of nurses' care experiences and hospital organizational structure. It identifies how the unique needs of caring for infants and families from a SEP increase the complexity of power imbalances and organizational constraints to further increase workload demands. Findings have implications for global healthcare organization leaders who build and maintain the structural integrity of clinical environments and nurse leaders who advocate and guide clinical teams to provide high‐quality care in stressful healthcare environments.Reporting MethodEQUATOR guidelines were followed, using the COREQ checklist.Patient or Public ContributionNICU nurses were interviewed about their care‐provision experiences. Interviews were analysed in the primary study and the current analysis of secondary data.

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“…For some, the ability of intersectionality to address health inequalities has been limited due to the idealist (rather than scientific realist) ontology by which it lends to moral relativism (Muntaner & Augustinavicius, 2019). For others, the framework of intersectionality has held significant appeal (Barned et al, 2019;Grzanka & Brian, 2019). Nevertheless, these authors are critical of Wilson et al (2019a) because of their focus on the dyadic interactions between patients and clinicians, and argue that it diminishes the importance of other requirements of intersectionality, like social justice.…”

Section: The Conversation Startersmentioning

confidence: 99%

Integrating intersectionality into autonomy: Reflections on feminist bioethics and egg freezing

Proost

2021

DiGeSt - Journal of Diversity and Gender Studies

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The field of bioethics struggles with the complexity of diversity and power differences. ‘Intersectionality in Clinical Medicine: The Need for a Conceptual Framework’ (Wilson et al., 2019) and its accompanying commentaries, though inventive and thought-provoking, overlook key principles of biomedical ethics. In this paper, I reflect on the debate and consider how an intersectional approach could inform normative theorizing. Traditional principlist reasoning leads to serious problems when we are trying to deal with the complexities of intersectionality, and this is especially true if we look at the principle of autonomy. I develop the idea that intersectionality is more in line with feminist inquiry in bioethics that attempts to reconfigure autonomy. However, feminist critiques of autonomy often remain less than thoroughly engaged with intersectionality. The case of social egg freezing is used to further support this claim. By foregrounding an intersectional approach to the existing relational autonomy claims in this debate, the complicated relational and justice concerns of reproduction are better brought into focus.

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Addressing the Practical Implications of Intersectionality in Clinical Medicine: Ethical, Embodied and Institutional Dimensions

Cited by 12 publications

References 8 publications

What is intersectionality and why is it important in oral health research?

What is intersectionality and why is it important in oral health research?

Neonatal intensive care nurses' accounts of care for mothers/families with substance‐exposed pregnancies: A critical discourse analysis

Integrating intersectionality into autonomy: Reflections on feminist bioethics and egg freezing

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