Undergraduate medical ethics education currently focuses on ethical concepts and reasoning. This paper uses an intern’s story of an ethically challenging situation to argue that this emphasis is problematic in terms of ensuring students’ ethical practice as junior doctors. The story suggests that it is aligning their actions with the values that they reflectively embrace that can present difficulties for junior doctors working in the pressures of the hospital environment, rather than reasoning to an ethically appropriate action. I argue that (...) junior doctors need skills for implementing their ethical decisions and that these ought to form a central component of undergraduate medical ethics education. (shrink)

Medical professionals are a community of highly educated individuals with a commitment to a core set of ideals and principles. This community provides both technical and ethical socialization. The ideal physician is confident, empathic, forthright, respectful, and thorough. These ideals allow us to define broadly "the excellence" of being a physician. At the core of these ideals is the ability to be empathic. Empathy exhibits itself in attributes of an individual's moral character and also in actions that actualize and support (...) communal life. Empathy, however, can be diminished or even lost and must be nurtured on an ongoing basis. The development of ethical physicians is strongly linked to experiences in the training period. Moral traits are situation-sensitive psychological and behavioral dispositions. The clinical environment of medical training programs can be so intense as to lead to conditions that may actually deprofessionalize trainees. Creating a clinical environment that is ethically nurturing and sustaining is an indispensable component of practicing medicine. (shrink)

W pierwszej części artykułu charakteryzuję trzy rodzaje profesjonalizmu lekarskiego: profesjonalizm tradycyjny, odnowiony i kompleksowy. Omawiam także czynniki kulturowe, ekonomiczne i aksjologiczne wpływające na ich kształtowanie się. Stawiam tezę, że profesjonalizm kompleksowy ze względu na jego skomplikowanie i arbitralne wyodrębnianie elementów składowych jest nieprzydatny w edukacji moralnej studentów i lekarzy. W części drugiej rekonstruuję wady i zalety profesjonalizmu tradycyjnego i odnowionego. Uzasadniam pogląd, że najważniejsza zaleta profesjonalizmu wynika z jego ambiwalencji moralnej. Nie traktuję więc tej dwuznaczności jako wyłącznie wady. Lekarz profesjonalista (...) powinien mieć świadomość jasnych i ciemnych stron profesjonalizmu oraz umiejętność właściwego ich ważenia w danych okolicznościach – poszukiwania Arystotelesowskiego złotego środka. W ostatniej części argumentuję za umiarkowanie optymistycznym przekonaniem o przydatności profesjonalizmu tradycyjnego i odnowionego w moralnym formowaniu studentów medycyny i młodych lekarzy. (shrink)

This paper challenges the leading common morality accounts of medical ethics which hold that medical ethics is nothing but the ethics of everyday life applied to today’s high-tech medicine. Using illustrative examples, the paper shows that neither the Beauchamp and Childress four-principle account of medical ethics nor the Gertet al10-rule version is an adequate and appropriate guide for physicians’ actions. By demonstrating that medical ethics is distinctly different from the ethics of everyday life and cannot be derived from it, the (...) paper argues that medical professionals need a touchstone other than common morality for guiding their professional decisions. That conclusion implies that a new theory of medical ethics is needed to replace common morality as the standard for understanding how medical professionals should behave and what medical professionalism entails. En route to making this argument, the paper addresses fundamental issues that require clarification: what is a profession? how is a profession different from a role? how is medical ethics related to medical professionalism? The paper concludes with a preliminary sketch for a theory of medical ethics. (shrink)

Background Undergraduate medical education is beginning to concern itself with educating students about professional attributes as well as about clinical knowledge and skills. Defining these characteristics, and in particular seeking the help of the students themselves to define them, can be a useful starting point when considering how to incorporate aspects of professional behaviour into the medical curricula. Method This study explores the views of first-year medical students at Kocaeli University Faculty of Medicine in the 2007–8 academic year. The students (...) were asked the open-ended question: ‘What, in your opinion, are the attributes a good physician should have?’ Four topics were defined by researchers based on the undergraduate and graduate education projects. The attributes expressed by the students were evaluated by the researchers according to these topics and compared with the topics covered in the undergraduate and graduate education projects. Results A total of 127 students responded, and between them suggested 756 attributes. The majority of these attributes (54.6%) were concerned with interpersonal relations and communication, whereas the category representing the fewest attributes (12.3%) was that involving scientific knowledge and medical practice. In general, students' perception corresponded to the concept of the ‘competent physician’ as described in the professionalism projects, but attributes reflecting their world-view were also expressed. Conclusion Experience suggests that the active participation of students in determining which attributes are necessary for a good physician is a positive way of ensuring they embrace the importance of such qualities and attributes in themselves. (shrink)

Background: The opinions of students regarding the attributes of a good nurse can make a major contribution to the planning and the conducting of professional education. There are few studies which aim at identifying the qualifications of a good nurse from the perspectives of nursing students. Objectives: To determine the opinions of first- and fourth-year nursing students concerning the ‘attributes of a good nurse’, and whether and how their views change depending on their year of study. Research design: Descriptive research. (...) Participants and research context: This study was conducted in the nursing department of a vocational school of health in the 2010/2011 academic year. The study participants consisted of first-year and intern students. A survey form was used to identify characteristics of participants, and students were asked the following open-ended question about their opinions related to the attributes of a good nurse. Ethical considerations: The permission was taken from the school administration. Informed consent was obtained, and anonymity was ensured for participating students. Findings: A total of 120 students participated in this study. Most frequently expressed attributes were ‘professional competence’ in first-year and ‘responsibility’ in fourth-year students. While first-year students placed a greater emphasis on the attributes of ‘geniality’, ‘patience’, ‘calmness’, ‘love of nursing’, ‘loyalty to nursing’ and ‘not attaching importance to material values’, fourth-year students emphasized the attributes of ‘empathy’, ‘honesty’, ‘responsibility’ and ‘scientific curiosity’ significantly more. Discussion and conclusion: Fourth-year students placed a greater emphasis on the attributes which the students are expected to acquire through a nursing program and clinical experience. However, they mentioned the attributes related to a good nurse–patient relationship and communication significantly less. Appropriate ethical training methods and good role models can help students acquire attributes that are important for the nursing profession and combine them with the attributes they already have. (shrink)

This paper challenges the long-standing and widely accepted view that medical ethics is nothing more than common morality applied to clinical matters. It argues against Tom Beauchamp and James Childress’s four principles; Bernard Gert, K. Danner Clouser and Charles Culver’s ten rules; and Albert Jonsen, Mark Siegler, and William Winslade’s four topics approaches to medical ethics. First, a negative argument shows that common morality does not provide an account of medical ethics and then a positive argument demonstrates why the medical (...) profession requires its own distinctive ethics. The paper also provides a way to distinguish roles and professions and an account of the distinctive duties of medical ethics. It concludes by emphasizing ways in which the uncommon morality approach to medical ethics is markedly different from the common morality approach. (shrink)

ABSTRACT Perpetuation of privileged norming in organizations threatens the fragile hope that the theory and practice of professionalism can evolve alongside commitments to equity and inclusion. Uncritical engagement with a normative professionalism can lead to the muting of differences and strengths that diverse standpoints offer to professional communities. We look to the field of Medicine as an example for other professional groups, in which experts have criticized its development of a normative professionalism shaped by, retaining, and sustaining privilege. Using a (...) triad of case studies and co-cultural theory, we suggest that non-dominant perspectives and behaviors ought to be better recognized and welcomed as part of professionalism discourse, and that professional education ought to include co-cultural awareness of communication behaviors and their function as identity performance. We suggest that recognizing and reinforcing accommodation behaviors will lead to a more robust inclusivity for an evolving normativity, and that the wisdom habits of curiosity, perspective, love of learning, judgment, and creativity must be brought to bear on improving co-cultural dialogue, dismantling systemic privilege, practicing attributional complexity, and building genuinely dialogic professional communities rather than depersonalized collectives. (shrink)