不确定性不是问题;这是一个促进可能性的悖论:来自关键残疾研究的三种策略,用于重构未知
Ryan R Weber1, Amanda M Caleb1
1Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA.
Teaching and learning in medicine
|June 19, 2025
概括
在医学中重新定义不确定性和残疾可以改善患者的护理. 通过采用接受不确定性和挑战能力主义实践的策略,医疗保健可以促进更大的公平性和以人为中心的方法.
科学领域:
- 医学伦理 医学伦理
- 关于残疾人的研究.
- 医学社会学 医学社会学
背景情况:
- 不确定性和残疾是医学中重要但未被充分探索的领域.
- 当前的医学文化往往负面地看待不确定性和残疾,受偏见和能力主义行为的影响.
- 对确定性和治疗残疾的过度强调导致了负面的患者结果和医生倦怠.
研究的目的:
- 在临床环境中探索不确定性和残疾之间的相互作用.
- 提出将不确定性重新定义为医疗保健中的积极力量的策略.
- 倡导一个更公平,以人为中心的医疗保健方法.
主要方法:
- 利用残疾的社会模型来告知重构策略.
- 应用Paul Han的宽容框架来解决偏见和心理模型.
- 通过认知正义的批判性镜头来检查知识系统和标签.
- 纳入来自残疾人活动主义的概念,比如伊利·克莱尔的"不选择残疾".
主要成果:
- 提出了三种相互关联的策略,将不确定性重新定义为一种可能性来源.
- 重新评估心理模型可以拆除结构性障碍并保持主观性.
- 重新审视知识的方式可以促进认识论的正义,并挑战能力主义的逻辑.
- 恢复不确定性,而不是避免残疾,可以培养意义和改善关系护理.
结论:
- 建立了一种实践,以培养医学中对不确定性和身体变化的容忍度.
- 拥抱悖论和不适可以将不确定性从局限性转变为解放力量.
- 这些策略有助于建立一个更加公平,以人为中心的医疗文化,促进认识系统的正义.
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