Recent global events demonstrate that analytical frameworks to aid professionals in healthcare ethics must consider the pervasive role of social structures in the emergence of bioethical issues. To address this, the authors propose a new sociologically informed approach to healthcare ethics that they term “social bioethics.” Their approach is animated by the interpretive social sciences to highlight how social structures operate vis-à-vis the everyday practices and moral reasoning of individuals, a phenomenon known as social discourse. As an exemplar, the authors (...) use social bioethics to reframe common ethical issues in psychiatric services and discuss potential implications. Lastly, the authors discuss how social bioethics illuminates the ways healthcare ethics consultants in both policy and clinical decision-making participate in and shape broader social, political, and economic systems, which then cyclically informs the design and delivery of healthcare. (shrink)

This article examines neuroleptics in relation to the histories of biopsychiatry and neoliberalism in the United States. Drawing from Foucault's concept of biopower, I contend that neuroleptics are socially constructed as a mechanism to address underlying biological illnesses in order to achieve neoliberal subjectivity for mad/disabled people. I then argue this biopsychiatric and neoliberal construct dominates services with the expressed goal of creating people who self‐govern their own drug consumption. This, however, contrasts with accounts that depict intersubjective balancing acts between (...) treatment providers and mad/disabled people, who must incorporate the various effects of psychoactive drugs beyond measures of rehabilitation. In doing so, I advocate for new lines of psychological inquiry that critically examine the structural determinants of poverty and the underlying constructions of citizenship and wellness. (shrink)

In the wake of injustices in healthcare, the field of clinical ethics consultation would benefit from new methods that support ethicists in addressing the role of intersecting systems of oppression in healthcare decision-making.1 We argue for an expanded view of Delany and colleagues’ critical dialogue method to accomplish this by integrating a constructivist lens.2 By doing so, critical dialogue holds the potential to not only encourage a deeper examination of operating moral assumptions but also offers an important framework for examining (...) how underlying social structures shape ethical reasoning in clinical cases.3 As a first step in consultation methods, ethicists are often encouraged to solicit the viewpoints of treatment teams. Taking a constructivist viewpoint, these encounters can reveal to ethicists the narratives that teams share, which are iteratively developed through patient and treatment team interactions, and play a central role in how teams interpret cases. Further, consider that concepts in clinical ethics cases can directly contribute to the characterisation of patients by treatment teams, such as decisional capacity or agreeableness to care. In this regard, how treatment teams frame ethical concerns is not necessarily a direct reflection of the core issues; rather, their interpretations are partially rooted in narratives about patients and the interpersonal dynamics through …. (shrink)

Background: This study examines the views of bioethicists in the US and Canada on incorporating social justice into their work and the field more broadly.Methods: Through an iterative process with leaders in bioethics, we created a survey and distributed it via bioethics listservs and individual emails.Results: Ultimately, we received responses from 355 bioethicists in the US and Canada. Respondents showed strong support for integrating social justice concerns, with 80% endorsing its inclusion in bioethics and 75% believing it should be a (...) key aim of bioethics scholarship. However, engagement with specific social justice topics varied, and perceptions about institutional support for doing so were mixed. Early-career bioethicists were more likely to support integrating social justice into bioethics.Conclusion: Our findings highlight the importance of prioritizing social justice within bioethics and underscore the need for institutional support to advance these efforts. (shrink)