Violations of a shared humanity: A scoping review

Abstract

Understanding how power can serve to either safeguard or violate humanity lays the groundwork for examining the instances of violation. Nurses must ensure that they prioritize individual’s needs through awareness of structural barriers and processes, such as decision-making and resource allocations, to ensure healthcare delivery is equitable. Therefore, the review aimed to investigate what is known from the existing literature regarding violations of a shared humanity by nurses to oppress and dehumanize individuals seeking healthcare. The scoping review adopted Arksey and O’Malley's framework to guide data analysis. Numerous databases and platforms were utilized to explore studies that focus on violations perpetrated by nurses. These included Biblioteca Virtual en Salud (BVS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Dialnet, Elsevier, Google Scholar, Medline, ResearchGate, Redalyc, and Scielo. Articles published in English, French, Portuguese, and Spanish between 1972 and 2023 were analyzed. A total of 46 articles from the original 1078 articles were included. The analyses revealed three central themes such as dehumanization, the presence of both unconscious and conscious biases, and medicalizing rationality utilizing a thematic analysis approach to discern patterns. These phenomena emerge as effects of systems of oppression and structures of power, whose primary support and expression lie in persistent symbolic and structural violence. Interest in understanding this phenomenon is evident by 50% of the studies published since 2016. The findings revealed that conscious and unconscious violations have been documented against individuals seeking healthcare. A call to action to wade into this uncomfortable discussion, within all practice domains, must occur to mitigate violations because of the power dynamics between a nurse and patient. Addressing these acts in clinical practice through policy, legal recourse, and professional regulatory associations is mitigating harm towards individuals seeking healthcare. This problem is a global phenomenon (18 countries) in multiple settings.

Keywords: Dehumanization, intersectionality, nurse, oppression, power, violation