Abstract：
AbstractCommunity-based \"free\" clinics can be a key site of primary and preventive care, especially for underserved members of the community. Ethical issues arise in community clinics. Despite this-and the fact that ethics consultation is a well-established practice within hospitals-ethics support is rarely integrated within community clinics, and the clinical ethicist\'s role in community care settings remains unexplored. In this article I explore what community-engaged practice might look like for the clinical ethicist. I share my experience of being invited into a local community clinic where a team of volunteers, in partnership with a local church, provide care to persons experiencing housing and food security in our county. First, I outline some of the key ethical issues we encounter in our clinic, including how to promote the agency of community members, develop shared standards for clinic volunteers, and balance different values and priorities within the partnership. Second, I explore how the ethicist\'s knowledge and skills translate into this setting. I argue that, given the range of ethical issues that arise in community clinics and the need for ongoing dialogue, education, and critical reflection within such partnerships, there is a role for the clinical ethicist in this space. I discuss how clinical ethicists might begin to develop community-based partnerships and practices.
摘要：
以社区为基础的“免费”诊所可以成为初级和预防保健的关键场所，特别是对于服务不足的社区成员。伦理问题出现在社区诊所。尽管如此，道德咨询在医院中是一种行之有效的做法，但道德支持很少被整合到社区诊所中，而临床伦理学家在社区护理环境中的作用仍未被探索。在本文中，我探讨了临床伦理学家的社区参与实践可能是什么样子。我分享了我被邀请进入当地社区诊所的经验，那里有一群志愿者，与当地教会合作，为在我们县经历住房和粮食安全的人提供护理。首先,我概述了我们在诊所遇到的一些关键道德问题，包括如何促进社区成员的代理，为诊所志愿者制定共同的标准，并在伙伴关系中平衡不同的价值观和优先事项。第二,我探索伦理学家的知识和技能如何转化为这种环境。我认为，鉴于社区诊所中出现的一系列道德问题以及持续对话的必要性，教育,以及这种伙伴关系中的批判性反思，临床伦理学家在这个领域有作用。我讨论了临床伦理学家如何开始发展基于社区的伙伴关系和实践。
