:Although recent literature on professionalism in healthcare abounds in recommended character traits, attitudes, or behaviors, with a few exceptions, the recommendations are untethered to any serious consideration of the contours and ethical demands of the healing relationship. This article offers an approach based on the professional’s commitment to trustworthiness in response to the vulnerability of those seeking professional help. Because our willingness and ability to trust health professionals or healthcare institutions are affected by our personality, culture, race, age, prior experiences (...) with illness and healthcare, and socioeconomic and political circumstances—“the social determinants of trust”—the attitudes and behaviors that actually do gain trust are patient and context specific. Therefore, in addition to the commitment to cultivating attitudes and behaviors that embody trustworthiness, professionalism also includes the commitment to actually gaining a patient’s or family’s trust by learning, through individualized dialogue, which conditions would win their justified trust, given their particular history and social situation. (shrink)

Formal teaching of ethics in health science programs at the entry level and postprofessional level in the United States and Canada has been documented in the professional literature for more than 30 years, yet there are significant differences in the way it is taught and how much time is devoted to the subject. Numerous teaching and evaluation methods have been used in ethics education, such as lectures, written examinations, debates, role-playing, small group discussion, and case study analysis. Most instruction in (...) ethics in the health sciences has been geared toward ethical analysis of case studies, that is, the student is asked to read a case or discuss a case with others, identify the ethical issues verbally or in writing, propose different resolutions supported by principles and theory, and select the best course of action. Yet, analysis of a case is an unlikely route to develop skills in coping with the uncertainty and emotional nature of ethical issues commonly encountered in clinical practice, nor does it give us an indication of what students would “really do” when they encounter an actual ethical problem. (shrink)

Biomedical ethics is an essential part of the medical curriculum because it is thought to enrich moral reflection and conduce to ethical decisionmaking and ethical behavior. In recent years, however, the received idea that competency in moral reasoning leads to moral responsibility “in the field” has been the subject of sustained attention. Today, moral education and development research widely recognize moral reasoning as being but one among at least four distinguishable dimensions of psychological moral functioning alongside moral motivation, moral character, (...) and moral sensitivity. In a reflection of this framework, medical educators and curriculum planners repeatedly advance the idea that educators should be concerned with supporting empathy, and this, very often, as a means of improving on and broadening medical ethics education’s traditional focus on moral reasoning. (shrink)