Abstract

Trauma is the number one public health problem in America today. Acute treatment of the injured patient requires a specialized method of health care delivery. As a response to this problem trauma care systems have been developed. Although this is an area where there is a great opportunity to decrease death and disability, unequal access to optimal care for the injured patient prevails today. ;A philosophical inquiry utilizing both critical social theory and Marxist critique has revealed the social, political, and economic barriers to access to optimal trauma care. It has also identified the current non-systematic approach to the care of the injured as a social phenomenon perceived as a form of oppression and injustice. ;In response to this finding a critical analysis into the theories of justice as espoused by Marx, Rawls, Daniels and Ryan ensued. It revealed that justice when emerging from a social arrangement can serve as an ideological tool that fosters the dominant ideology. Therefore, to avoid ideological manipulation, a notion of justice emerging from the person has been proposed. As advocates for the injured patient, nurses must enact their moral agency and influence trauma care policy. Advocacy on the patients' behalf invokes not only an ethic of justice based on personhood, but also the ethic of care; it transcends and integrates both care and justice perspectives. ;Public policy shaped by the integration of the ethic of care and the ethic of justice will function in the best interest of the injured patient and not the powerful minority. This inquiry has demonstrated that transforming an environment from one that hinders the development of human potential to one that fosters its development can be achieved by using a caring-based justice approach