Pediatric ethicists hold a privileged position of influence within health care institutions. Such a position confers a corresponding responsibility to address barriers to the health and flourishing of all children. A major barrier to children’s health is racism. Pediatric ethicists can, and should, leverage their position to address racism both in institutional policy and the provision of pediatric care. Health care’s historical and continued contributions to fostering and sustaining racist values and systems mean that those within all medical fields— regardless of race, ethnicity, gender, age, or profession—should consider ways they can work to offset and ultimately dismantle those values and systems. Institutional policy is a critical mechanism propagating racism in hospitals and an area where ethicists have a unique perspective to bring antiracism into ethical analysis. Many institutional and organizational policies have unintended consequences, negatively impacting children and families who have been historically marginalized and oppressed. In this paper, we report and discuss existing policies, along with how they are implemented (procedures) and how they are conducted (practices), identified through a workshop during a pediatric subgroup meeting at an annual bioethics conference. We highlight the need to focus on these structural factors and reference scholarship that can be used to correct institutional policies that uphold white supremacy. We conclude with actionable, concrete recommendations for change.
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September 2023
Special Articles|
August 10 2023
Antiracism: An Ethical Imperative
Ian Wolfe, PhD, MA, RN, HEC-C;
aClinical Ethics Department, Children’s Minnesota, Minneapolis, Minnesota
bCenter for Bioethics, University of Minnesota, Minneapolis, Minnesota
Address correspondence to Ian Wolfe, PhD, MA, RN, HEC-C, Children’s Minnesota, Mail Stop 17-750, 2525 Chicago Ave S, Minneapolis, MN 55404. E-mail: Ian.wolfe@childrensmn.org
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Bryanna Moore, PhD;
Bryanna Moore, PhD
cInstitute for Bioethics and Health Humanities, University of Texas Medical Branch, Galveston, Texas
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Lynn Bush, PhD, MS, MA;
Lynn Bush, PhD, MS, MA
dBoston Children’s Hospital, Boston, Massachusetts
eHarvard Medical School, Boston, Massachusetts
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Angela Knackstedt, BSN, RN-BC;
Angela Knackstedt, BSN, RN-BC
fChildren’s Mercy Bioethics Center, Kansas City, Missouri
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Sabrina Derrington, MD, MA, HEC-C;
Sabrina Derrington, MD, MA, HEC-C
gChildren’s Hospital Los Angeles Center for Bioethics, Los Angeles, California
hKeck School of Medicine, University of Southern California, Los Angeles, California
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K. Sarah Hoehn, MD, MBe, FAAP;
K. Sarah Hoehn, MD, MBe, FAAP
iDepartment of Pediatrics, University of Chicago, Chicago, Illinois
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Liza-Marie Johnson, MD, MPH, MSB;
Liza-Marie Johnson, MD, MPH, MSB
jSt. Jude Children’s Research Hospital, Memphis, Tennessee
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Sarah Porter, MSW;
Sarah Porter, MSW
kRandall Children’s Hospital, Portland, Oregon
lPortland State University, Portland, Oregon
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Amy Caruso Brown, MD, MSc, MSCS, HEC-C, FAAP
Amy Caruso Brown, MD, MSc, MSCS, HEC-C, FAAP
mCenter for Bioethics and Humanities
nDepartment of Pediatrics, State University of New York, Upstate Medical University, Syracuse, New York
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Address correspondence to Ian Wolfe, PhD, MA, RN, HEC-C, Children’s Minnesota, Mail Stop 17-750, 2525 Chicago Ave S, Minneapolis, MN 55404. E-mail: Ian.wolfe@childrensmn.org
Pediatrics (2023) 152 (3): e2022059804.
Article history
Accepted:
May 23 2023
Citation
Ian Wolfe, Bryanna Moore, Lynn Bush, Angela Knackstedt, Sabrina Derrington, K. Sarah Hoehn, Liza-Marie Johnson, Sarah Porter, Amy Caruso Brown; Antiracism: An Ethical Imperative. Pediatrics September 2023; 152 (3): e2022059804. 10.1542/peds.2022-059804
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