A Heresy of No Consequence: Duties and Virtues in Medicine and Professionalism.

In The Trusted Doctor: Medical Ethics and Professionalism (2020), Rosamond Rhodes presents a new theory of medical ethics based on 16 duties she considers central to medical ethics and professionalism. She asserts that her theory is "bioethical heresy," as it contradicts established "principlism" and "common morality" approaches to ethics in medicine. Rhodes advocates the development of parallelism between clinical and ethical decision-making and a systematic approach that emphasizes duties over principles and rules to facilitate the development of a "doctorly character" among medical decision-makers. Rhodes further asserts that her theory and approach necessitate the cultivation of virtues contained in Aristotle's Nicomachean Ethics. But Rhodes's insistence that "medical professionals," not just doctors, are covered by her theory is open to critique, as is her conflation of ethic and morals, especially around the question of the "doctorly character" upon which her duty-based theory hinges. This assessment argues that applicants to medical schools and allied health training programs be screened for specific virtues-honesty, diligence, curiosity, and compassion-to facilitate reinforcement of these pre-professionalized inclinations throughout the habituation processes of medical training. This would increase the probability of turning fear and hope to cure and care via reasoning and affective models performed within an ethical medical framework-even while what this ethical framework should reference remains under debate.

Ethical and Professional Considerations in Integrated Behavioral Health.

Integrated behavioral health models of care offer many benefits for patient experience and outcomes. However, multidisciplinary teams are comprised of professionals who each may have different professional norms and ethical obligations, which may at times be in conflict. This article offers a framework for negotiating potential conflicts between professional norms and expectations across disciplines involved in integrated behavioral health teams.

How Should Health Professionalism Be Redefined to Address Health Equity?

Increasing focus on health equity is placing a spotlight on health professionals' roles. Recent public health crises-the opioid epidemic, maternal mortality, and the COVID-19 pandemic-have renewed focus on racial and ethnic inequity and underscored that trust is foundational to public health and health professionalism. Organizational, system, and policy reform demand that professionalism be redefined in terms of its capacity to motivate equity in health professions education and clinical practice.

Ethical Considerations in Pediatricians' Use of Social Media.

Increasing use of social media by patients and clinicians creates opportunities as well as dilemmas for pediatricians, who must recognize the inherent ethical and legal complexity of these communication platforms and maintain professionalism in all contexts. Social media can be a useful tool in the practice of medicine by educating both physicians and patients, expanding access to health care, identifying high-risk behaviors, contributing to research, promoting networking and online support, enhancing advocacy, and nurturing professional compassion. At the same time, there are confidentiality, privacy, professionalism, and boundary issues that need to be considered whenever potential interactions occur between physicians and patients via social media. This clinical report is designed to assist pediatricians in identifying and navigating ethical issues to harness the opportunities and avoid the pitfalls of social media.

La ciudadela (1938) de King Vidor: luces y sombras en el ejercicio de la profesionalidad / The Citadel (1938) by King Vidor: Lights and shadows in the practice of professionalism

La ciudadela (1938) de King Vidor, es una película que narra la vida profesional del doctor Andrew Manson, desde su entusiasmado inicio como médico recién graduado en un pueblo minero en Gales, donde labora apasionadamente en diferentes casos sin importar las circunstancias, hasta su llegada a Londres donde ve distorsionado su propósito al adentrarse en la élite de la ciudad. Con la ayuda de su esposa Christine, tratará de recobrar el significado de la medicina. A través del filme se exhibe la ligera línea que divide el buen ejercicio de la profesionalidad. Por ello, en el presente trabajo se reflexiona sobre la medicina como profesión, su relación con la sociedad y se destaca la importancia de la educación en humanidades para el fortalecimiento del discernimiento ético en los futuros profesionales en salud. (AU)

The Citadel (1938) by King Vidor, is a film that narrates the professional life of Dr. Andrew Manson, from his enthusiastic start as a recently graduated doctor in a mining town in Wales, where he works passionately in different cases regardless of the circumstances, until his arrival in London where he sees his purpose distorted as he enters the elite of the city. With the help of his wife Christine, he will try to regain the meaning of medicine. Throughout the film the thin line that divides the good exercise of professionalism is exhibited. For this reason, this paper reflects on medicine as a profession, its relationship with society, and highlights the importance of education in the humanities for strengthening ethical discernment in future health professionals. (AU)

Ethical and professionalism issues in dermatopathology: A cross-sectional survey of American Society of Dermatopathology Members.

BACKGROUND: Data regarding ethical/professional issues affecting dermatopathologists are lacking despite their importance in establishing policy priorities and educational content for dermatopathology. METHODS: A 14-item cross-sectional survey about ethical/professional issues in dermatopathology was distributed over e-mail to members of the American Society of Dermatopathology from June to September 2019. RESULTS: Two hundred sixteen surveys were completed, with a response rate of 15.3%. Respondents ranked appropriate and fair utilization of healthcare resources (n = 83 or 38.6%) as the most often encountered ethical/professional issue. Conflict of interest was ranked as the most urgent or important ethical/professional issue (n = 83 or 39.3%). One hundred thirty-three (61.6%) respondents felt "somewhat" or "not at all" well equipped to handle ethical dilemmas in practice and 47 (22.8%) respondents identified a major or extreme burden (eg, have considered resigning/retiring) due to ethical challenges. CONCLUSIONS: Areas of priority in ethics and professionalism issues can guide future policy and educational content in dermatopathology.

Social representation of fair price among professional photographers.

We investigated the social representation of fair price of French and English-speaking photographers using the free association method. In two independent studies, we performed a factorial analysis of correspondence of the words provided by the participants as well as a similitude analysis. The results indicated that "fair price" was mainly associated with time, effort and experience level of photographers. Both French- and English-speaking samples made similar associations around the concept of fair price but the order of importance varied. We observed some gender-related differences in both samples, although the relative number of male and female participants must be taken into consideration.

Maintaining High Professional Standards, morally, ethically and fairly: what doctors need to know right now.

Facing an investigation into performance concerns can be one of the most traumatic events in a doctor's career, and badly handled investigations can lead to severe distress. Yet there is no systematic way for National Health Service (NHS) Trusts to record the frequency of investigations, and extremely little data on the long-term outcomes of such action for the doctors. The document-Maintaining High Professional Standards in the Modern NHS (a framework for the initial investigation of concerns about doctors and dentists in the NHS)-should protect doctors from facing unfair or mismanaged performance management procedures, which include conduct, capability and health. Equally, it provides NHS Trusts with a framework that must be adhered to when managing performance concerns regarding doctors. Yet, very few doctors have even heard of it or know about the provisions it contains for their protection, and the implementation of the framework appears to be very variable across NHS Trusts. By empowering all doctors with the knowledge of what performance management procedures exist and how best practice should be implemented, we aim to ensure that they are informed participants in any investigation should it occur.

Teaching Professional Formation in Response to the COVID-19 Pandemic.

In response to the COVID-19 pandemic, the Association of American Medical Colleges has called for a temporary suspension of clinical teaching activities for medical students. Planning for the continued involvement of learners in patient care during this pandemic should include teaching learners professional formation. The authors provide an ethical framework to guide such teaching, based on the ethical principle of beneficence and the professional virtues of courage and self-sacrifice from professional ethics in medicine. The authors show that these concepts support the conclusion that learners are ethically obligated to accept reasonable, but not unreasonable, risk. Based on this ethical framework, the authors provide an account of the process of teaching professional formation that medical educators and academic leaders should implement. Medical educators and academic leaders should embrace the opportunity that the COVID-19 pandemic presents for teaching professional formation. Learners should acquire the conceptual vocabulary of professional formation. Learners should recognize that risk of infection from patients is unavoidable. Learners should become aware of established ethical standards for professional responsibility during epidemics from the history of medicine. Learners should master understandable fear. Medical educators and academic leaders should ensure that didactic teaching of professional formation continues when it becomes justified to end learners' participation in the processes of patient care; topics should include the professionally responsible management of scarce medical resources. The COVID-19 pandemic will not be the last major infectious disease that puts learners at risk. Professional ethics in medicine provides powerful conceptual tools that can be used as an ethical framework to guide medical educators to teach learners, who will bear leadership responsibilities in responses to future pandemics, professional formation.