An intersectional framework uncovers several valuable sites of engagement for the study of clinical encounters: the position of individuals within larger institutional structures of power, their representation in dominant discourses, and the impact of lived experiences of difference and oppression on clinical care and practice. Intersectionality moves beyond the outlook of a strictly biomedical approach to illness and pathology and offers a unique perspective on the broader social, institutional, material, and discursive contexts in which these encounters unfold. As such, we agree with Wilson and colleagues (2019) that its application in the context of clinical encounters is extremely promising and long overdue. Our main concern, however, lies in the practical implementation of this framework to clinical contexts. While the authors explicitly acknowledge that intersectionality does not offer a “how to” manual for clinical medicine, or an unequivocal blueprint for ethical action, we argue that further discussion is required to understand the scope and conditions of its application. Furthermore, while Wilson and colleagues propose a much-needed structural analysis of the conditions that enable and hinder the development of personal awareness and ethical sensibility, the article begs the question of its implications for broader institutions and remains largely centered on dyadic interactions between individual clinicians and patients. We argue that an intersectional appro ach can and should transform medical approaches to care and help identify and redress conditions of structural inequity, but we suggest that its incorporation into clinical medicine requires more concrete details about its applicability. We stress that clinical encounters do not occur in a vacuum, and note institutional, embodied, and ethical aspects to consider when reflecting on the role of intersectionality in clinical medicine.

 

Claudia Barned, Corinne Lajoie & Eric Racine (2019) Addressing the Practical Implications of Intersectionality in Clinical Medicine: Ethical, Embodied and Institutional Dimensions, The American Journal of Bioethics, 19:2, 27-29, DOI: 10.1080/15265161.2018.1557278