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    This essay introduces a transformative justice framework to address how intersecting oppressions, like racism and classism, create healthcare ethics dilemmas. It centers marginalized voices to improve care and resolve ethical challenges.

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    Area of Science:

    • Clinical Ethics
    • Bioethics
    • Health Equity

    Background:

    • Clinical ethics consultants observe how intersecting oppressions (e.g., racism, classism) create healthcare ethical dilemmas.
    • Current Health Care Ethics Consultation (HCEC) guidance acknowledges power dynamics but relies on bioethical principles criticized for insufficiency.
    • Individual consultants adapt approaches ad hoc, lacking consistent frameworks for analyzing social-structural obstacles.

    Purpose of the Study:

    • To propose a novel framework for clinical ethics consultation.
    • To enhance the analysis of power imbalances and social-structural obstacles in healthcare.
    • To center and respect marginalized voices and value systems within ethical decision-making.

    Main Methods:

    • Grounded in transformative justice principles.
    • Integrates practical expertise from clinical ethicists.
    • Offers a structured approach to analyzing oppression in healthcare ethics.

    Main Results:

    • Provides a framework for consistent analysis of power dynamics in HCEC.
    • Supports the integration of marginalized perspectives into ethical problem-solving.
    • Encourages a proactive approach to addressing systemic oppression in healthcare.

    Conclusions:

    • The proposed framework offers a more robust approach to resolving complex healthcare ethical dilemmas.
    • Centering marginalized voices through transformative justice can lead to more equitable and effective care.
    • This framework supports ethical consultants in addressing the direct harms of oppression in health care.