Atonement in Professional Life: Conceptualizing Physician Restoration After Medical Error
Carl Hildebrand, Centre for Medical Ethics and Law, The University of Hong Kong, and Ashley Moyse, PhD, Department of Religion, Baylor University and Harris Manchester College, University of Oxford 

Medical error is a reality within medical practice because human practitioners are inherently fallible. While the consequences for patients are often immediate and severe, the enduring moral and existential impact on physicians is less visible while often profound. This paper argues that existing frameworks oriented around forgiveness are not best suited for guiding physicians toward moral restoration after error. Drawing on Alasdair MacIntyre’s conception of practice and virtue, we propose atonement as a central moral practice within medicine. Unlike forgiveness, which relies upon the response of the injured party, atonement is understood as an active, agent-centered process by which physicians can acknowledge error, make amends, and restore their professional and moral identity. We critically assess the limitations of both institutional responses and rituals such as Mortality and Morbidity conferences and offer a revised account of atonement comprising repentance, apology, reparation, and ongoing commitment to care. We suggest that atonement should be cultivated through structured, communal practices that integrate ethical mentorship, institutional support, and opportunities for reflection. In so doing, we reconceive professional flourishing not as the absence of error, but as the capacity to confront and integrate error and therefore grow through failure. This approach reframes medical error as a pedagogical moment—central to the development of virtues such as humility, courage, and fidelity—and argues that atonement is integral to the moral formation and flourishing of physicians.