26 found
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  1. Social media opposition to the 2022/2023 UK nurse strikes.Erika Kalocsányiová, Ryan Essex, Sorcha A. Brophy & Veena Sriram - forthcoming - Nursing Inquiry:e12600.
    Previous research has established that the success of strikes, and social movements more broadly, depends on their ability to garner support from the public. However, there is scant published research investigating the response of the public to strike action by healthcare workers. In this study, we address this gap through a study of public responses to UK nursing strikes in 2022–2023, using a data set drawn from Twitter of more than 2300 publicly available tweets. We focus on negative tweets, investigating (...)
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  2.  19
    The justification for strike action in healthcare: A systematic critical interpretive synthesis.Ryan Essex & Sharon Marie Weldon - 2022 - Nursing Ethics 29 (5):1152-1173.
    Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike action, identifying relative (...)
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  3.  9
    Resistance in health and healthcare.Ryan Essex - 2021 - Bioethics 35 (5):480-486.
    In this article I will introduce and outline the concept of resistance as it relates to health and healthcare. Starting with a number of examples of action, I will then turn to the broader literature to discuss some conventional definitions and related concepts, outlining debates, controversies and limitations related to conceptualizing resistance. I conceptualize resistance broadly, as any act, performed by any individual (or collective) acting as or explicitly identifying as a healthcare professional, that is a response to power, most (...)
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  4.  14
    How Resistance Shapes Health and Well-Being.Ryan Essex - 2022 - Journal of Bioethical Inquiry 19 (2):315-325.
    Resistance involves a range of actions such as disobedience, insubordination, misbehaviour, agitation, advocacy, subversion, and opposition. Action that occurs both publicly, privately, and day-to-day in the delivery of care, in discourse and knowledge. In this article I will demonstrate how resistance plays an important role in shaping health and well-being, for better and worse. To show how it can be largely productive and protective, I will argue that resistance intersects with health in at least two ways. First, it acts as (...)
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  5.  9
    A last resort? A scoping review of patient and healthcare worker attitudes toward strike action.Ryan Essex, Calvin Burns, Thomas Rhys Evans, Georgina Hudson, Austin Parsons & Sharon Marie Weldon - 2023 - Nursing Inquiry 30 (2):e12535.
    While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the (...)
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  6.  13
    Do codes of ethics and position statements help guide ethical decision making in Australian immigration detention centres?Ryan Essex - 2019 - BMC Medical Ethics 20 (1):1-9.
    Australian immigration detention has been called state sanctioned abuse and a crime against humanity. The Australian healthcare community has been closely involved with these policies, calling for their reform and working within detention centres to provide healthcare. As well as having a devastating impact on health, immigration detention changes the scope and nature of healthcare, with its delivery described as a Sisyphean task. In this article I will explore the guidance that is available to clinicians who work within detention centres (...)
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  7.  21
    Should clinicians boycott Australian immigration detention?Ryan Essex - 2019 - Journal of Medical Ethics 45 (2):79-83.
    Australian immigration detention has been called state sanctioned abuse, cruel and degrading and likened to torture. Clinicians have long worked both within the system providing healthcare and outside of it advocating for broader social and political change. It has now been over 25 years and little, if anything, has changed. The government has continued to consolidate power to enforce these policies and has continued to attempt to silence dissent. It was in this context that a boycott was raised as a (...)
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  8.  4
    A deliberative framework to assess the justifiability of strike action in healthcare.Ryan Essex - forthcoming - Nursing Ethics.
    Healthcare strikes have been a remarkably common and varied phenomenon. Strikes have taken a number of forms, lasting from days to months, involving a range of different staff and impacting a range of healthcare systems, structured and resourced vastly differently. While there has been much debate about strike action, this appears to have done little to resolve the often polarising debate that surrounds such action. Building on the existing normative literature and a recent synthesis of the empirical literature, this paper (...)
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  9.  9
    Healthcare and complicity in Australian immigration detention.Ryan Essex - 2016 - Monash Bioethics Review 34 (2):136-147.
    Australian immigration detention has received persistent criticism since its introduction almost 25 years ago. With the recent introduction of offshore processing, these criticisms have intensified. Riots, violence, self-harm, abuse and devastating mental health outcomes are all now well documented, along with a number of deaths. Clinicians have played a central role working in these environments, faced with the overarching issue of delivering healthcare while facilitating an abusive and harmful system. Since the re-introduction of offshore processing a number of authors have (...)
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  10.  16
    Do codes of ethics and position statements help guide ethical decision making in Australian immigration detention centres?Ryan Essex - 2019 - BMC Medical Ethics 20 (1):52.
    Australian immigration detention has been called state sanctioned abuse and a crime against humanity. The Australian healthcare community has been closely involved with these policies, calling for their reform and working within detention centres to provide healthcare. As well as having a devastating impact on health, immigration detention changes the scope and nature of healthcare, with its delivery described as a Sisyphean task. In this article I will explore the guidance that is available to clinicians who work within detention centres (...)
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  11.  23
    Human Rights, Dual Loyalties, and Clinical Independence: Challenges Facing Mental Health Professionals Working in Australia’s Immigration Detention Network.Ryan Essex - 2014 - Journal of Bioethical Inquiry 11 (1):75-83.
    Although Australia has comparatively few individuals seeking asylum, it has had a mandatory detention policy in place since 1992. This policy has been maintained by successive governments despite the overwhelmingly negative impact mandatory detention has on mental health. For mental health professionals working in this environment, a number of moral, ethical, and human rights issues are raised. These issues are discussed here, with a focus on dual loyalty conflicts and drawing on personal experience, the bioethics and human rights literature, and (...)
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  12.  10
    Everyday Resistance in the U.K.’s National Health Service.Ryan Essex, Jess Dillard-Wright, Guy Aitchison & Hil Aked - forthcoming - Journal of Bioethical Inquiry:1-11.
    Resistance is a concept understudied in the context of health and healthcare. This is in part because visible forms of social protest are sometimes understood as incongruent with professional identity, leading healthcare workers to separate their visible actions from their working life. Resistance takes many forms, however, and focusing exclusively on the visible means more subtle forms of everyday resistance are likely to be missed. The overarching aim of this study was to explore how resistance was enacted within the workplace (...)
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  13.  16
    Self-harm in immigration detention: political, not (just) medical.Guy Aitchison & Ryan Essex - forthcoming - Journal of Medical Ethics.
    Self-harm within immigration detention centres has been a widely documented phenomenon, occurring at far higher rates than the wider community. Evidence suggests that factors such as the conditions of detention and uncertainty about refugee status are among the most prominent precipitators of self-harm. While important in explaining self-harm, this is not the entire story. In this paper, we argue for a more overtly political interpretation of detainee self-harm as resistance and assess the ethical implications of this view, drawing on interviews (...)
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  14.  16
    Anarchy and Its Overlooked Role in Health and Healthcare.Ryan Essex - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):397-405.
    In this paper, I will argue that a number of well-known health interventions or initiatives could be considered anarchist, or at the very least are consistent with anarchist thinking and principles. In doing this I have two aims: First, anarchism is a misunderstood term—by way of example, I hope to first sketch out what anarchist solutions in health and healthcare could look like; second, I hope to show how anarchist thought could stand as a means to improve the health of (...)
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  15.  8
    A scoping review exploring the impact and negotiation of hierarchy in healthcare organisations.Ryan Essex, Jack Kennedy, Denise Miller & Jill Jameson - 2023 - Nursing Inquiry 30 (4):e12571.
    Healthcare organisations are hierarchical; almost all are organised around the ranking of individuals by authority or status, whether this be based on profession, expertise, gender or ethnicity. Hierarchy is important for several reasons; it shapes the delivery of care, what is prioritised and who receives care. It also has an impact on healthcare workers and how they work and communicate together in organisations. The purpose of this scoping review is to explore the qualitative evidence related to hierarchy in healthcare organisations (...)
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  16.  8
    Exploring the concept of non-violent resistance amongst healthcare workers.Ryan Essex, Hil Aked, Rebecca Daniels, Paul Newton & Sharon Weldon - 2023 - Nursing Ethics 30 (1):7-19.
    BackgroundNon-violent resistance which has involved healthcare workers has been instrumental in securing a number of health-related gains and a force in opposing threats to health. Despite this, we...
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  17.  8
    Give incivility a chance.Ryan Essex & Lydia Mainey - 2023 - Journal of Medical Ethics 49 (10):679-680.
    Civility is a nice idea. While we find common ground with the aspirations of a civility-based professional culture in healthcare and acknowledge the potential impacts of incivility on staff and patients, we should be careful in dismissing it entirely, as McCullough et al 1 do. As we will argue below, appeals to civility, when understood alongside power, could serve to stifle and mask legitimate dissent, limiting genuine criticism and progress. Crucially, we contend that incivility itself may serve instrumental and communicative (...)
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  18.  18
    Ethics, Foreseeability, and Tragedy in Australian Immigration Detention.Ryan Essex - 2015 - Journal of Bioethical Inquiry 12 (4):537-539.
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  19.  20
    Torture, healthcare and Australian immigration detention.Ryan Essex - 2016 - Journal of Medical Ethics 42 (7):418-419.
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  20.  33
    The Ethics of Discharging Asylum Seekers to Harm: A Case From Australia.Ryan Essex & David Isaacs - 2018 - Journal of Bioethical Inquiry 15 (1):39-44.
    In February 2016 a twelve-month-old asylum seeker, who came to be know as Baby Asha, was transferred from Nauru and hospitalized in Brisbane. This case came to public attention after Doctors refused to discharge Asha as she would have been returned to detention on Nauru. What in other circumstances would have been considered routine clinical care, quickly turned into an act of civil disobedience. This paper will discuss the ethical aspects of this case, along with its implications for clinicians and (...)
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  21.  20
    Ethical climate in healthcare: A systematic review and meta-analysis.Ryan Essex, Trevor Thompson, Thomas Rhys Evans, Vanessa Fortune, Erika Kalocsányiová, Denise Miller, Marianne Markowski & Helen Elliott - 2023 - Nursing Ethics 30 (7-8):910-921.
    Background Ethical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviour within teams. Aim This paper sought to explore perceptions of ethical climate amongst healthcare workers as measured by the Ethical Climate Questionnaire (ECQ), the Hospital Ethical Climate Survey (HECS) and the Ethics Environment Questionnaire (EEQ). Methods A systematic review and meta-analysis was utilised. PSYCINFO, CINAHL, WEB OF SCIENCE, MEDLINE and EMBASE were searched, and papers were included if they (...)
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  22.  11
    Resistance and the delivery of healthcare in Australian immigration detention centres.Ryan Essex & Michael Dudley - 2023 - Monash Bioethics Review 41 (1):82-95.
    There are few issues that have been as vexing for the Australian healthcare community as the Australian governments policy of mandatory, indefinite, immigration detention. While many concepts have been used to begin to describe the many dilemmas faced by healthcare professionals and their resolution, they are limited, perhaps most fundamentally by the fact that immigration detention is antithetical to health and wellbeing. Furthermore, and while most advice recognises that the abolition of detention is the only option in overcoming these issues, (...)
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  23.  11
    The delivery of health services as resistance.Ryan Essex - 2023 - Bioethics 37 (8):756-762.
    In this article, I will argue that the delivery of healthcare could be an act of resistance, that is, day‐to‐day, routine and perhaps mundane acts, undertaken in the course of the delivery of health services, which for many could also be considered otherwise routine care. I first consider how resistance has been conceptualised. How we understand resistance will determine if we believe healthcare could be conceptualised this way. I will show how resistance has been applied to day‐to‐day struggles elsewhere and (...)
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  24.  26
    Structural injustice and dismantling racism in health and healthcare.Ryan Essex, Marianne Markowski & Denise Miller - 2022 - Nursing Inquiry 29 (1).
    Racism in health and healthcare has long been recognised as a structural issue. While there has been growing research and a number of important initiatives that have come from approaching racism as a structural issue, there is a range of implications that yet have to be explored as they relate to health and healthcare. Conceptualising racism in this way provides a means to consider how it shapes and is shaped by a range of global injustices and serves as a foundation (...)
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  25.  10
    Codes of Ethics, Human Rights and Forced Migration.Ryan Essex - 2021 - American Journal of Bioethics 21 (1):31-33.
    The COVID-19 pandemic has led to the largest sudden global change to community life in living memory. Since being declared a pandemic in early 2020, there has been a growing body of evidence that h...
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  26.  9
    Justifying non-violent resistance: The perspectives of healthcare workers.Ryan Essex, Hil Aked, Rebecca Daniels, Paul Newton & Sharon M. Weldon - forthcoming - Clinical Ethics.
    Introduction: Non-violent resistance, carried out by healthcare workers, has been a common phenomenon. Despite this and despite the issues this type of action raises, we know little about the healthcare workers who engage in this action and their perspectives about its justification. This exploratory study sought to address this gap, examining these fundamental questions amongst a sample of healthcare workers who have engaged in acts of resistance, exploring their understanding of non-violent resistance, its justification and the barriers they faced in (...)
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