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

Main Article Content

Kazimierz Szewczyk
https://orcid.org/0000-0002-4255-4824

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.

Downloads

Download data is not yet available.

Article Details

How to Cite
Szewczyk, Kazimierz. 2019. “Forms of Medical Professionalism and Their Usefulness in the Moral Education of Medical Students and Young Physicians”. Diametros 16 (62), 33-64. https://doi.org/10.33392/diam.1231.
Section
Articles
Author Biography

Kazimierz Szewczyk, University of Warsaw

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

Share |

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.


DOI
View in Google Scholar

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].
View in Google Scholar

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.
View in Google Scholar

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.
View in Google Scholar

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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.
View in Google Scholar


View in Google Scholar

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


DOI
View in Google Scholar

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 =


DOI
View in Google Scholar

http://www.nejm.org/doi/pdf/10.1056/NEJMp1407373 [dostęp 25.06.2018].
View in Google Scholar

Bogusz J. (1984), Lekarz i jego chorzy, PZWL, Warszawa.
View in Google Scholar

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

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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.
View in Google Scholar

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.
View in Google Scholar

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.
View in Google Scholar

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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].


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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

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].
View in Google Scholar

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.


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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.
View in Google Scholar

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.
View in Google Scholar

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


DOI
View in Google Scholar

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.
View in Google Scholar

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


DOI
View in Google Scholar

Gołota M. (2017), Lekarze nie chodzą do psychiatry, a powinni, Gazeta.pl, URL =
View in Google Scholar

http://weekend.gazeta.pl/weekend/1,152121,21961063,polscy-lekarze-nie-chodza-do-psychiatry-a-powinni-zdarza.html [dostęp 27.06.2018].
View in Google Scholar

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.
View in Google Scholar

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


DOI
View in Google Scholar

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.


DOI
View in Google Scholar

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.
View in Google Scholar

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

Janczukowicz J. (red.) (2014), Profesjonalizm lekarski, Medical Tribune Polska, Warszawa.
View in Google Scholar

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


DOI
View in Google Scholar

Karta lekarza (2013), tłum. P. Gajewski, A. Juda, J. Mrukowicz, W. Strojny, „Medycyna Praktyczna”, URL =
View in Google Scholar

https://www.mp.pl/etyka/dokumenty/86822,karta-lekarza [dostęp 20.06.2018].
View in Google Scholar

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

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

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

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

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


DOI
View in Google Scholar

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

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.


DOI
View in Google Scholar

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

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.
View in Google Scholar

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

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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

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

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.
View in Google Scholar

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


DOI
View in Google Scholar

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


DOI
View in Google Scholar

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.
View in Google Scholar

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

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.
View in Google Scholar

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.
View in Google Scholar

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

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].
View in Google Scholar

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

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

Tulczyński A. (1975), Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa.
View in Google Scholar

Uniwersytet Medyczny w Białymstoku (2017), Profesjonalizm w medycynie, URL =
View in Google Scholar

https://www.umb.edu.pl/pdf.php?h=/s,12782/Sylabus&1529227616397.
View in Google Scholar

Uniwersytet Warmińsko-Mazurski (2017), Elementy profesjonalizmu, URL =
View in Google Scholar

https://usosweb.uwm.edu.pl/kontroler.php?_action=katalog2/przedmioty/pokazPrzedmiot&kod=2548SJ-ELOP.
View in Google Scholar

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


DOI
View in Google Scholar

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.
View in Google Scholar

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.
View in Google Scholar

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


DOI
View in Google Scholar

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

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