结构性污名、法律流行病学和COVID-19:采取上游行动的道德必要性

IF 1.1 4区 哲学 Q3 ETHICS Kennedy Institute of Ethics Journal Pub Date : 2020-11-14 DOI:10.1353/ken.2020.0018
D. Goldberg
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引用次数: 1

摘要

摘要:本文的主要主张是,新冠肺炎耻辱必须被理解为一种结构性现象。这样做将为我们选择并优先考虑的干预措施提供信息,以改善这种污名化,这是道德上的优先事项。将污名视为由结构性因素驱动的健康的宏观社会决定因素表明,下游补救措施不太可能有效减少污名。本文发展并捍卫了这一主张,提出了一项建议,即在微观和宏观层面使用“一揽子”法律和政策杠杆,以减少新冠肺炎耻辱的不利和不公平影响。在第二节中,本评论对污名的概念进行了一般性的基本描述,将其概念化为一种结构性现象的理由,以及这样做的一些基本优势,但也要强调利用法律和政策作为公共卫生变革的杠杆。第四节敦促明确采用法律流行病学的见解和方法,并举例说明解决这些污名的具体法律和政策建议。第五节结束。
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Structural Stigma, Legal Epidemiology, and COVID-19: The Ethical Imperative to Act Upstream
ABSTRACT:The primary claim of this paper is that COVID-19 stigma must be understood as a structural phenomenon. Doing so will inform the interventions we select and prioritize for the amelioration of such stigma, which is an ethical priority. Thinking about stigma as a macrosocial determinant of health driven by structural factors suggests that downstream remedies are unlikely to be effective in significantly reducing stigma. This paper develops and defends this claim, setting up a recommendation to use a “bundle” of legal and policy levers at meso- and macro- levels to reduce the adverse and inequitable impact of COVID-19 stigma. In Section II, this commentary offers a basic account of the concept of stigma in general, the justification for conceptualizing it as a structural phenomenon, and some of the basic advantages of doing so. Section III moves on to frame infectious and communicable disease stigma in Western history not only as a way of demonstrating its structural features, but also to highlight the use of laws and policies as levers for public health change. Section IV urges explicit adoption of insights and methods from legal epidemiology and offers examples of specific legal and policy recommendations for addressing these stigmas. Section V concludes.
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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
19
期刊介绍: The Kennedy Institute of Ethics Journal offers a scholarly forum for diverse views on major issues in bioethics, such as analysis and critique of principlism, feminist perspectives in bioethics, the work of the Advisory Committee on Human Radiation Experiments, active euthanasia, genetics, health care reform, and organ transplantation. Each issue includes "Scope Notes," an overview and extensive annotated bibliography on a specific topic in bioethics, and "Bioethics Inside the Beltway," a report written by a Washington insider updating bioethics activities on the federal level.
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