Marginalisation as a possible health issue: An exercise in practice-based ethical education

Abstract

With the point of departure in the ongoing discussion of the professional and moral responsibility for those who are not equally included in the established health services, the question of how to include individuals and groups facing marginalisation is one of the major challenges within the ethics of care. This makes marginalisation a core concept in our time, which is challenged by, among other things, differentness with respect to ethnicity and social status as well as breach with norms and laws. The representation of individuals and groups facing marginalisation is not merely an intellectual question, however, but an epistemological one with political, practical and ethical implications. This article discusses a pilot project exploring what we can do within nursing education to sensitise students to professional and moral responsibility for individuals and groups facing marginalisation. A dialogical approach to knowledge, including cooperation with voluntary organisations and low-threshold facilities with a long tradition of trying to prevent people from 'falling through the net', was chosen to highlight the professional challenges and the ethical dilemmas that arise in the interface between closeness and distance, caring and marginalisation. Evaluation of data indicated that such an approach to knowledge seems to benefit the students' learning.