Combatting the crisis: virtue ethics as foundation for a universal medical professionalism in the 21st Century

Date
2020-12
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Medical professionalism is facing an existential crisis globally, one brought about by factors both internal and external to the profession. These include, amongst others, the increasing commercialisation, commodification and bureaucratisation of healthcare, the increasing division of medicine into specialities and sub-specialitiesvyingamongst each otherfor a monopoly on certain skills and knowledge, a generational change in moral values and, ironically, the rise of the bioethics movement with an insistence that respect for autonomy be given primacy above all other considerations. This state of vulnerability is compounded by the modern medical profession floundering in a moral smorgasbord of principles, rules, duties, values and virtues to try and undergird medical professionalism. In this thesis I argue that medical professionalismis in such crisis precisely because grounding it in principlism and other broad-based moral theories such as Kantianism and Utilitarianism is untenable. Medicineis, andhas always been,a moral enterprise, consisting of a rich millennia-old moral tradition unrestrained by cultural and national boundaries, and which is practiced within a moral community with specific role-generated moral valuesand responsibilities. I argue that a virtue-basedapproach, with the telosof medicine being found in the healing relationship between physician and patient, gives a coherent, comprehensive and normative account of medical professionalism, even in the 21stcentury.
AFRIKAANSE OPSOMMING: iiiOpsommingMediese professionalismeondergaan huidiglik ‘n wereld-wye eksistensiele krisis, een wat aangebring is deur faktore beide intern en ekstern tot die professie. Hierdie faktore bestaan onder meer uit, die toename in die kommersialisering, kommodofiseringen burokratiseringvan gesondheid, the toename in die verdeling van medisyne in spesialisasies en sub-spesialisasies wat tussen mekaar veg vir ‘n monopolie op sekere vaardighede en kennis, ‘n generasie verandering in morele waardes en, ironies, die onstaan van die bioetiese beweging wataandring dat respek vir outonomiteit voorrang moet geniet bo enige ander oorweging. Hierdie kwesbare standword vererger deur die mediese professiese poging om mediese professionalismedeur ‘n onsamehangende mengsel van prinsiepe, reels, pligte, waardes en deugdes te regverdig. In hierdie tesis, beredeneer ek dat mediese professionalisme homself in so krisis bevind juis omdat dit gegrond probeer word in prinsipalisme en ander bree-gebaseerde morele teoriee soos Kantianisme en Utilitarisme. Medisyneis, en was nogaltyd, ‘n morele onderneming wat bestaan uit ‘n ryk, eeue-oue,morele tradisie oningeperk deur kulturele of nasionale grense, en wat beoefen word binne ‘n morele gemeenskap met sy eie rol-gegenereerde morele waardes en verantwoordelikhede. Ek beredeneer dat ‘n deugde-gebaseerdebenadering, waar die telosvan medisyne binne die genesings-verhouding tussen die geneesheer en die pasient gevind word, ‘n samehangende, ekstensiewe en normatiewe verklaring van mediese professionalisme bied, selfs in die 21ste eeu.
Description
Thesis (MPhil)--Stellenbosch University, 2020.
Keywords
UCTD, Medical ethics, Medical profession -- Ethics, Bioethics
Citation