In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous (...) physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)

It is central to virtue ethics both that morally sound action follows from virtuous character, and that virtuous character is itself the product of habitual right judgement and choice: that, in short, we choose our moral characters. However, any such view may appear to encounter difficulty in those cases of moral conflict where an agent cannot simultaneously act (say) both honestly and sympathetically, and in which the choices of agents seem to favour the construction of different moral characters. This paper (...) argues, against possible counter-arguments, for a view of virtue ethics which embraces the diversity of moral character. (shrink)

Role modeling is widely thought to be a principal vehicle for acquiring the virtues. Yet, little is known about role modeling as a process. This paper surveys the behavioral sciences for insights about how one person can find the actions of another person so inspirational that the person attempts to reproduce the behavior in question. In general, such inspiration occurs when an observer sees a model similar to herself, wrestling with a problem she is having, such that the model’s accomplishments (...) are seen as attainable. When the behavior modeled is moral, additional complications arise, not the least of which is the contemporary skepticism about anyone held up as a hero. The paper concludes with some suggestions about how organizations can facilitate the development of the virtues through role modeling. (shrink)

Objective—To report the ethical development of medical students across four years of education at one medical school.Design and setting—A questionnaire was distributed to all four classes at the Wake Forest University School of Medicine during the Spring of 1996. Participants—Three hundred and three students provided demographic information as well as information concerning their ethical development both as current medical students and future interns. Main measurements—Results were analyzed using cross-tabulations, correlations, and analysis of variance.Results—Results suggested that the observation of and participation (...) in unethical conduct1 may have disparaging effects on medical students' codes of ethics with 35% of the total sample (24% of first years rising to 55% of fourth years) stating that derogatory comments made by residents/attendings, either in the patient's presence or absence, were “sometimes” or “often” appropriate. However, approximately 70% of the sample contended that their personal code of ethics had not changed since beginning medical school and would not change as a resident. Conclusions—Results may represent an internal struggle that detracts from the medical school experience, both as a person and as a doctor. Our goal as educators is to alter the educational environment so that acceptance of such behaviour is not considered part of becoming a physician. (shrink)

The purpose of this study was to evaluate the effectiveness of plagiarism detection software and penalty for plagiarizing in detecting and deterring plagiarism among medical students. The study was a continuation of previously published research in which second-year medicals students from 2001/2002 and 2002/2003 school years were required to write an essay based on one of the four scientific articles offered by the instructor. Students from 2004/2005 (N = 92) included in present study were given the same task. Topics of (...) two of the four articles were considered less complex, and two were more complex. One less and one more complex articles were available only as hardcopies, whereas the other two were available in electronic format. The students from 2001/2002 (N = 111) were only told to write an original essay, whereas the students from 2002/2003 (N = 87) were additionally warned against plagiarism, explained what plagiarism was, and how to avoid it. The students from 2004/2005 were warned that their essays would be examined by plagiarism detection software and that those who had plagiarized would be penalized. Students from 2004/2005 plagiarized significantly less of their essays than students from the previous two groups (2% vs. 17% vs. 21%, respectively, P P P < 0.001) as a source for their essays, but it did not influence the rate of plagiarism. Use of plagiarism detection software in evaluation of essays and consequent penalties had effectively deterred students from plagiarizing. (shrink)

Previous research indicates that students in engineering self-report cheating in college at higher rates than those in most other disciplines. Prior work also suggests that participation in one deviant behavior is a reasonable predictor of future deviant behavior. This combination of factors leads to a situation where engineering students who frequently participate in academic dishonesty are more likely to make unethical decisions in professional practice. To investigate this scenario, we propose the hypotheses that (1) there are similarities in the decision-making (...) processes used by engineering students when considering whether or not to participate in academic and professional dishonesty, and (2) prior academic dishonesty by engineering students is an indicator of future decisions to act dishonestly. Our sample consisted of undergraduate engineering students from two technically-oriented private universities. As a group, the sample reported working full-time an average of six months per year as professionals in addition to attending classes during the remaining six months. This combination of both academic and professional experience provides a sample of students who are experienced in both settings. Responses to open-ended questions on an exploratory survey indicate that students identify common themes in describing both temptations to cheat or to violate workplace policies and factors which caused them to hesitate in acting unethically, thus supporting our first hypothesis and laying the foundation for future surveys having forced-choice responses. As indicated by the responses to forced-choice questions for the engineering students surveyed, there is a relationship between self-reported rates of cheating in high school and decisions to cheat in college and to violate workplace policies; supporting our second hypothesis. Thus, this exploratory study demonstrates connections between decision-making about both academic and professional dishonesty. If better understood, these connections could lead to practical approaches for encouraging ethical behavior in the academic setting, which might then influence future ethical decision-making in workplace settings. (shrink)

As medical education increasingly acknowledges the importance of the ethical and professional conduct of practitioners, and moves towards more formal assessment of these issues, it is important to consider the evidence base which exists in this area. This article discusses literature about the health needs and problems experienced by medical practitioners as a background to a review of the current efforts in medical education to promote ethical conduct and develop mechanisms for the detection and remediation of problems.