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. 2021 Jul;51(4):22-31.
doi: 10.1002/hast.1269.

Activism and the Clinical Ethicist

Christopher Meyers

Activism and the Clinical Ethicist

Christopher Meyers. Hastings Cent Rep. 2021 Jul.

Abstract

Although clinical ethics scholarship and practice has largely avoided assuming an activist stance, the many health care crises of the last eighteen months motivated a distinct change: On listserves, in blog postings, and in published essays, activist language has permeated conversations over such issues as the impact of triage policies on persons with disabilities and of color, and how the health care system has historically failed African Americans. In this paper, I defend this turn, arguing that clinical ethicists should embrace activism-generally, and with particular emphasis on institutional, mesolevel concerns. Ethicists are often uniquely situated to understand the structural factors that regularly motivate clinical ethics cases, and they are often in a privileged position to be effective change agents. In making this case, I also stress the need not to overstep one's skills and to be acutely cognizant of the political risks associated with such work.

Keywords: activism; advocacy; clinical ethics; ethicist; institutional structures.

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References

Notes

    1. See, for example, the 2019 special issue Bioethics and Activism in Bioethics (33, no. 8) and the 2016 “Addressing Racism” essays in the American Journal of Bioethics 16, no. 4.
    1. R. Baker, “Race and Bioethics: Bioethical Engagement with a Four-Letter Word,” American Journal of Bioethics 16, no. 4 (2016): 16-18, at 16.
    1. I focus here on those who have at least part-time clinical ethics responsibilities. There is also a rich tradition of macrolevel activism from self-identified bioethicists whose primary work is as university scholars and teachers. See, for example, K. Ray, “Intersectionality and Power Imbalances Clinicians of Color Face When Patients Request White Clinicians,” American Journal of Bioethics 19, no. 2 (2019): 25-26, and J. Stramondo, “Why Bioethics Needs a Disability Moral Psychology,” Hastings Center Report 46, no. 3 (2016): 22-30.
    1. See in particular J. L. Scully, “The Responsibilities of the Engaged Bioethicist: Scholar, Advocate, Activist,” Bioethics 33, no. 8 (2019): 872-80, and L. Parker, “Bioethics as Activism,” in The Ethics of Bioethics: Mapping the Moral Landscape, ed. L. Eckenwiler and F. Cohn (New York: Oxford University Press, 2007), 144-57.
    1. These limitations are, of course, also a structural flaw.

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