Forms of medical professionalism and their usefulness in the moral education of medical students and young physicians

Main Article Content

Kazimierz Szewczyk

Abstract

In the article I discuss three types of medical professionalism: traditional, renewed and complex. I also discuss cultural, economic and axiological factors that influence their development. I advance the thesis that complex professionalism is of no avail in the moral education of students and physicians, due to its complicated nature and the arbitrary manner of the specification of its components. In the second, part I reconstruct and present some of the advantages and drawbacks to both traditional and renewed professionalism. I attempt to justify the view that the greatest advantage of professionalism lies in its moral ambivalence. A professional physician should be aware of the advantages and disadvantages of professionalism and should be able to properly weigh them under the given circumstances – they should seek Aristotle’s golden mean. In the final part of the article I argue for a moderately optimistic belief regarding the utility of traditional and renewed professionalism in the moral development of medical students and young doctors.

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How to Cite
SZEWCZYK, K. Forms of medical professionalism and their usefulness in the moral education of medical students and young physicians. Diametros, v. 16, n. 62, p. 33-64, 28 Aug. 2019.
Section
Articles
Author Biography

Kazimierz Szewczyk, University of Warsaw

Kazimierz Szewczyk, dr hab.
Instytut Filozofii UW
ul. Krakowskie Przedmieście 3
00-927 Warszawa

References

ABIM Foundation, ACP–ASIM Foundation, European Federation of Internal Medicine (2002), Medical Professionalism in the New Millennium: A Physician Charter, „Annals of Internal Medicine” 136 (3): 243–246.

American Medical Association (1847), Code of Medical Ethics, Chicago, URL = https://www.ama-assn.org/sites/default/files/media-browser/public/ethics/1847code_0.pdf [dostęp 16.06.2018].

American Medical Association (1999), Principles of Medical Ethics, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel, S. Latham (red.), Johns Hopkins University Press, Baltimore 1999: 346–354.

Baker R.B. (1999), The American Medical Ethics Revolution, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel, S. Latham (red.), Johns Hopkins University Press, Baltimore: 17–51.

Baker R.B. (2002), Bioethics and History, „Journal of Medicine and Philosophy” 27 (4): 447–474.

Baker R.B. (2013), Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution, Oxford University Press, Oxford.

Baker R.B., Caplan A., Emanuel L., Latham S. (1999), Introduction, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel, S. Latham (red.), Johns Hopkins University Press, Baltimore: XXXII–XXXIX.

Beaton G. (2010), What Professionalism Is Still Relevant?, „Legal Studies Research Paper” 445, Melbourne Law School: 1–23.

Blendon R.J., Benson J.M., Hero J.O. (2014), Public Trust in Physicians – U.S. Medicine in International Perspective, „New England Journal of Medicine” 371 (17): 1570–1572, URL =
http://www.nejm.org/doi/pdf/10.1056/NEJMp1407373 [dostęp 25.06.2018].

Bogusz J. (1984), Lekarz i jego chorzy, PZWL, Warszawa.

Bogusz J. (1985), Zasady deontologiczne związane z postępami wiedzy lekarskiej, [w:] Etyka i deontologia lekarska, T. Kielanowski (red.), PZWL, Warszawa: 77–116.

Boyd K.M. (2005), Medical Ethics: Principles, Persons, and Perspectives: From Controversy to Conversation, „Journal of Medical Ethics” 31 (8): 481–486.

Brecher B. (2004), Against Professional Ethics, „Philosophy of Management” 4 (2): 3–8.

Brennan T.A. (2002), Physicians’ Professional Responsibility to Improve the Quality of Care, „Academic Medicine” 77 (10): 973–980.

Brody H., Doukas D. (2014), Professionalism: A Framework to Guide Medical Education, „Medical Education” 48 (10): 980–987.

Callahan D. (1984), Autonomy: A Moral Good Not a Moral Obsession, „Hastings Center Report” 14 (5): 40–42.

Capron M.A. (1999), Professionalism and Professional Ethics, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel, S. Latham (red.), Johns Hopkins University Press, Baltimore: 180–191.

Cassell E.J. (2013), The Beginnings of Bioethics, [w:] The Development of Bioethics in the United States, J.R. Garrett, F. Jotterand, D.Ch. Ralston (red.), Springer, Dordrecht: 16–25.

Castellani B., Hafferty F.W. (2006), The Complexities of Medical Professionalism: A Preliminary Investigation, [w:] Professionalism in Medicine: Critical Perspectives, D. Wear, J.M. Aultman (red.), Springer, New York: 3–24.

Clements C.D., Sider R.C. (1983), Medical Ethics’ Assault Upon Medical Values, „Journal of American Medical Association” 250 (15): 2011–2015.

Coulehan J. (2005), Today’s Professionalism: Engaging the Mind but Not the Heart, „Academic Medicine” 80 (10): 892–898.

De M. (2004), Towards Defining Paternalism in Medicine, „AMA Journal of Ethics” 6 (2), URL = http://journalofethics.ama-assn.org/2004/02/fred1-0402.html [dostęp 20.06.2019].

Dunn M. (2016), On the Relationship Between Medical Ethics and Medical Professionalism, „Journal of Medical Ethics” 42 (10): 625–626.

Dzur A.W. (2008), Democratic Professionalism. Citizen Participation and the Reconstruction of Professional Ethics, Identity, and Practice, Pennsylvania State University Press, University Park.

Encyklopedia Warmii i Mazur (bdw.), Ceremonia białego fartucha, URL = http://encyklopedia.warmia.mazury.pl/index.php/Ceremonia_Bia%C5%82ego_Fartucha#Bibliografia [dostęp 26.06.2018].

Erde E.L. (1997), The Inadequacy of Role Models For Educating Medical Students in Ethics With Some Reflections on Virtue Theory, „Theoretical Medicine” 18 (1–2): 31–45.

Erde E.L. (2008), Professionalism's Facets: Ambiguity, Ambivalence, and Nostalgia, „Journal Medicine and Philosophy” 33 (1): 6–26.

Erde E.L. (2013), Professionalism vs. Medical Ethics in the Current Era: A Battle of Giants, [w:] The Development of Bioethics in the United States, J.R. Garrett, F. Jotterand, D.Ch. Ralston (red.), Springer, Dordrecht: 179–206.

Freidson E. (1999), Professionalism and Institutional Ethics, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel, S. Latham (red.), Johns Hopkins University Press, Baltimore: 124–143.

Gillon R. (2000), White Coat Ceremonies for New Medical Students, „Journal of Medical Ethics” 26 (2): 83–84.

Giubilini A., Milnes S., Savulescu J. (2016), The Medical Ethics Curriculum in Medical Schools: Present and Future, „Journal of Clinical Ethics” 27 (2): 129–145.

Goldberg J.L. (2008), Humanism or Professionalism? The White Coat Ceremony and Medical Education, „Academic Medicine” 83 (8): 715–722.

Gołota M. (2017), Lekarze nie chodzą do psychiatry, a powinni, Gazeta.pl, URL =
http://weekend.gazeta.pl/weekend/1,152121,21961063,polscy-lekarze-nie-chodza-do-psychiatry-a-powinni-zdarza.html [dostęp 27.06.2018].

Hafferty F.W. (2009), Professionalism and the Socialization of Medical Students, [w:] Teaching Medical Professionalism, R.L. Cruess, S.R. Cruess, Y. Steinert (red.), Cambridge University Press, Cambridge: 53–71.

Hafferty F.W., Franks R. (1994), The Hidden Curriculum, Ethics Teaching, and the Structure of Medical Education, „Academic Medicine” 69 (11): 861–871.

Hafferty F.W., Levinson D. (2008), Moving Beyond Nostalgia and Motives Towards a Complexity Science View of Medical Professionalism, „Perspectives in Biology and Medicine” 51 (4): 599–615.

Haidet P., Stein H.F. (2006), The Role of the Student-Teacher Relationship in the Formation of Physicians. The Hidden Curriculum as Process, „Journal of General Internal Medicine” 21 (Suppl. 1): S16–S20.

Inui T.S. (2003), A Flag in the Wind: Educating for Professionalism in Medicine, Association of American Medical Colleges, Washington.

Janczukowicz J. (red.) (2014), Profesjonalizm lekarski, Medical Tribune Polska, Warszawa.

Kaldjian F.Ch. (2014), Practicing Medicine and Ethics. Integrating Wisdom, Conscience, and Goals of Care, Cambridge University Press, New York.

Karta lekarza (2013), tłum. P. Gajewski, A. Juda, J. Mrukowicz, W. Strojny, „Medycyna Praktyczna”, URL =
https://www.mp.pl/etyka/dokumenty/86822,karta-lekarza [dostęp 20.06.2018].

Kenny N. Shelton W. (red.) (2006), Lost Virtue: Professional Character Development in Medical Education, Elsevier Ltd., Oxford.

Kowalska K., Kalbarczyk W.P. (2013), Koordynowana opieka zdrowotna. Doświadczenia międzynarodowe, propozycje dla Polski, Program EY „Sprawne Państwo”, Warszawa.

Kuczewski M.G. (2010), Teaching Biomedical Ethics As Professionalism, „Diametros” 25: 10–37.

Lindemann Nelson H., Lindemann Nelson J. (1995), The Patient in the Family. An Ethics of Medicine and Families, Rutledge, New York.

Łuków P. (2017), Non-adjectival Bioethics, „Ethics, Medicine and Public Health” 3 (4): 401–409.

Łuków P., Pasierski T. (2014), Etyka medyczna z elementami filozofii, PZWL, Warszawa.

Markakis K.M., Beckman H.B., Suchman A.L., Frankel R.M. (2000), The Path to Professionalism: Cultivating Humanistic Values and Attitudes in Residency Training, „Academic Medicine” 75 (2): 141–150.

McCullough L.B. (1998), John Gregory and the Invention of Professional Medical Ethics and The Profession of Medicine, Kluwer Academic Publishers, Dordrecht.

McCullough L.B. (2006), The Ethical Concept of Medicine: Its Origins in Modern Medical Ethics and Implication for Physicians, [w:] Lost Virtue: Professional Character Development in Medical Education, N. Kenny, W.N. Shelton (red.), Elsevier Ltd., Oxford: 17–28.

Michałowska M., Turek J. (2010), Pomoc i czyny obowiązkowe i ponadobowiązkowe w praktyce lekarskiej i bioetyce, „Etyka” 43: 125–142.

Montgomery J. (2006), Law and the Demoralization of Medicine, „Legal Studies” 26 (2): 185–210.

Montgomery J. (2016), Bioethics as Governance Practice, „Health Care Analysis” 24 (1): 3–23.

Olejniczak M. (2015), Jakiej sprawiedliwości wolno oczekiwać od lekarza?, „Diametros” 44: 78–88.

Pasierski T. (2009), Lekarz – zawód czy profesja, „Medycyna po Dyplomie” 18 (4): 133–135.

Rhodes R., Smith L.G. (2006), Molding Professional Character, [w:] Lost Virtue: Professional Character Development in Medical Education, N. Kenny, W.N. Shelton (red.), Elsevier Ltd., Oxford: 99–114.

Smith L.G. (2005), Medical Professionalism and the Generation Gap, „The American Journal of Medicine” 118 (4): 439–442.

Swick H.M. (2000), Toward a Normative Definition of Medical Professionalism, „Academic Medicine” 75 (6): 612–616.

Szewczyk K. (1996), Lęk, nicość i respirator. Wzorce śmierci w nowożytnej cywilizacji Zachodu, [w:] Umierać bez lęku. Wstęp do bioetyki kulturowej, M. Gałuszka, K. Szewczyk (red.), Wydawnictwo Naukowe PWN, Warszawa: 14–62.

Szewczyk K. (2009), Bioetyka. Medycyna na granicach życia, Wydawnictwo Naukowe PWN, Warszawa.

Szewczyk K. (2013), Status metodologiczny bioetyki (w demokratycznym społeczeństwie prawnym) i uniwersalność norm moralnych, [w:] Etyka w medycynie wczoraj i dziś, K. Basińska, J. Halasz (red.), Impuls, Kraków: 237–260.

Szewczyk K. (2016), Odpowiedzialność moralna lekarzy i bioetyka, [w:] Etyka w medycynie. Między teorią a praktyką, A. Paprocka-Lipińska, R. Budziński (red.), Gdański Uniwersytet Medyczny, Gdańsk: 24–62.

Szewczyk K. (2018), Kurs pozaformalny w edukacji studentów medycyny i młodych lekarzy, „Diametros” 57: 61–87.

Szewczyk K. (bdw), Kazus Zofii Szychowskiej – opis, Interdyscyplinarne Centrum Etyki UJ, URL = http://www.incet.uj.edu.pl/dzialy.php?l=pl&p=31&i=3&m=27&n=1&z=0&kk=486&k=103 [dostęp 26.06.2018].

Tauber A.I. (2005), Patient Autonomy and the Ethics of Responsibility, MIT Press, Cambridge.

Thomas L.-V. (1991), Trup. Od biologii do antropologii, Wydawnictwo Łódzkie, Łódź.

Tulczyński A. (1975), Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa.

Uniwersytet Medyczny w Białymstoku (2017), Profesjonalizm w medycynie, URL =
https://www.umb.edu.pl/pdf.php?h=/s,12782/Sylabus&1529227616397.

Uniwersytet Warmińsko-Mazurski (2017), Elementy profesjonalizmu, URL =
https://usosweb.uwm.edu.pl/kontroler.php?_action=katalog2/przedmioty/pokazPrzedmiot&kod=2548SJ-ELOP.

Veatch R.M. (2006), How Philosophy of Medicine Has Changed Medical Ethics, „Journal of Medicine and Philosophy” 31 (6): 585–600.

Veatch R.M. (2006), Character Formation In Professional Education: A Word of Caution, [w:] Lost Virtue: Professional Character Development in Medical Education, N. Kenny, W.N. Shelton (red.), Elsevier Ltd., Oxford: 29–46.

Veatch R.M. (2013), The Development of Bioethics: Bringing Physician Ethics into the Moral Consensus, [w:] The Development of Bioethics in the United States, J.R. Garrett, F. Jotterand, D.Ch. Ralston (red.), Springer, Dordrecht: 163–177.

Wear D., Kuczewski M.G. (2004), The Professionalism Movement: Can We Pause?, „The American Journal of Bioethics” 4 (2): 1–10.

Włodarczyk C., Badora-Musiał K. (2017), Trwałość niektórych wyobrażeń. Niespełnione obietnice profesjonalizmu, „Problemy Polityki Społecznej. Studia i Dyskusje” 36 (1): 43–62.

Wojcieszek P. (2006), Czasem myślę o gabinecie na plaży, [w:] K. Bochenek, D. Kortko, Dobry zawód (rozmowy z lekarzami), Znak, Kraków: 5–11.