Affective Injustice in Healthcare

This book explores the ambiguous role of affects in healthcare work and medical education. At the same time that healthcare professionals are often encouraged to suppress or downplay their affects in order to maintain a sense of professionalism, those of patients are frequently misunderstood or unheard - both within clinical settings and beyond. We argue that these are examples of affective injustice, instances in which emotional expression is dismissed as unprofessional, unproductive, or inappropriate in healthcare. We show that the suppression of affects is not only unrealistic but also potentially harmful, and how it can lead to burnout and dissatisfaction among healthcare providers as well as negatively affect care quality, in particular for marginalized groups. The ambition of the book is therefore to bring this controversial issue to the forefront and to demonstrate the value of affects in healthcare and medical education, as well as to offer several methodologies for greater affective expression and recognition in healthcare institutions. The first part of the book lays the theoretical groundwork, examining the relevance of the concept of affective injustice for healthcare, and the problems that affective injustice creates for care actors and for care quality. The second part offers some practical methodologies to move toward affective justice for patients and healthcare providers. Proposals include narrative methods, spiritual care, emotionally responsive hospital design and architecture, the possibilities and limits offered by patient research partners, and pedagogies for medical education. The book will end by showing how to take the framework forward, in particular through empirical bioethics research. This book will be of interest to scholars and educators in medical ethics, interdisciplinary researchers in the medical humanities, as well as patients, families, and healthcare providers interested in the role of affects in healthcare.