Reinvesting in social justice

Background: Public health nursing has urged its clinicians to reinvest in social justice. Drevdahl, Kneipp, Canales & Dorsey (2001) explain that social justice once flourished in public health because PH nurses were not constrained by the medical model and were concerned with population rather than individual health. However, when Bekemeier and Butterfield (2005) examined significant policy documents such as the 2001 Code of Ethics for Nurses, the 2004 Scope and Standards of Nursing Practice, and Nursing's Social Policy Statement (2003), through a social justice lens, they found ambiguous and conflicting statements about the meaning and application of social justice theory, notably an emphasis on individuals rather than populations and the common good. In stark contrast to social justice, the term “market justice” is frequently used to explain market oriented health care and managed care environments. Market justice values individualism, self-interest, and voluntary behavior. It is antithetical to the notions of the common good and concern for the poor. Market justice now influences the practice of public health nursing because many PH clients are enrolled in managed Medicaid programs, programs influenced by standardization and medical models. Description of program: Using Beauchamp's (1976) assertion “the ethical foundation of public health is social justice,” as a springboard, this presentation challenges educators and administrators to re-awaken interest in and knowledge of the social justice tradition in public health nursing. Fraser (2003) argues that a commitment to social justice requires distribution and recognition. This means that decisions about the distribution of health resources need to be participatory, transparent and public. Recognition occurs when those who use the language of social justice understand and articulate its meaning in public health settings and policy circles. Lessons learned: Contemporary nursing's understanding of social justice lacks semantic clarity. Without an organized program of distribution and recognition of social justice, market justice will dominate public health nursing practice. Recommendations: Develop/disseminate curriculum models to assist faculty to teach social justice theory and principles. Develop discussion models to facilitate dialogue and analysis of the intersection of public health nursing practice and social justice.