Vanquishing virtue: the impact of medical education

TitleVanquishing virtue: the impact of medical education
Publication TypeJournal Article
Year of Publication2001
AuthorsCoulehan, J, Williams, PC
JournalAcademic Medicine
Publication Languageeng
KeywordsAmerica , care , Culture , CURRICULUM , education , Education, , Humans , Innovation , Managed , Medical , North , Organizational , programs , SOCIAL , Socialization , VALUES
AbstractThis article discusses the moral commitments of North American physicians. Though many bring to their owrk a broad view of social responsibility, medical education in North America tends to favor traditional values of doctoring-empathy, compassion, and altruism, as well as commitment to tacit values grounded in an ethic of detachment, self-interest, and objectivity. Young physicians tend to solve the conflict between these two sets of ethical values in a number of ways, either by narrowing their professional identities to an ethic of competence, or by developing a kind of non-reflective professionalism, an implicit avowal that they best care for their patients by treating them as objects of technical services (medical care). Others develop an immunity to" against the tacit values, and internalize and develop professional virtue. The authors discuss how the new shift in the cultural of medicine has shifted to ambulatory settings and the marketplace, and ask if this change will lessen the disjunction between the explicit curriculum and the manifestly contradictory values of detachment and entitlement, and the belief that the patient's interest always coincides with the physician's interest.
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