Ordinary Time: Everyday Virtue Ethics and Patient-Physician Formation
Joshua Jiang, MD, University of California, Los Angeles, CA
Virtue-based medical ethics has drawn continued interest over and against other ethical models for its emphasis on goodness in the patient-physician relationship. Instead of using principles like the avoidance of harm to guide medical decisions, an ethic of virtue asks physicians and patients to develop qualities and habits of goodness and thus become the kind of people whose moral decisions proceed from their character.
Those who desire to guide their work by such an ethic are faced with lingering challenges: How does one practice and embody the habits of virtue and become a good doctor? What role, if any, does the physician have in the formation of a good patient if both parties ought to develop this type of character?
In this presentation, I will explore the complexities of applying virtue ethics to clinical life. I argue that the development of virtuous physicians requires everyday clinical encounters, which are like the passage of ordinary time on the church calendar. These intervals become needful spaces for deeper appreciation for and maturation of our conceptions of medicine; for learning to see, understand, and embody goodness. Contrary to expectation, I believe a routine visit with a patient in homeostasis and “not much going on” is a greater challenge for a physician’s practice of virtue than even when that same physician is tasked with caring for a patient in life-threatening circumstances.
Relatedly, I argue that the physician’s opportunity to participate in the formation of her patient’s character occurs most powerfully in the context of everyday medical encounters. Pellegrino and Thomasma identified multiple valences of goodness for physicians to pursue, the highest levels being “the good of the patient as a person” and “the spiritual good of the patient”. It is within our everyday encounters that the pursuit of these goods becomes dialogical between physician and patient, and expands to include social virtues.
The spectrum of medical care spans from crisis to quotidian, and many have rightfully considered the function of virtue in emergent situations. A greater coherence is required as we move from the ICU to the clinic, and the latter's unassuming quality nevertheless is fertile ground for becoming physicians and patients of virtue.
Those who desire to guide their work by such an ethic are faced with lingering challenges: How does one practice and embody the habits of virtue and become a good doctor? What role, if any, does the physician have in the formation of a good patient if both parties ought to develop this type of character?
In this presentation, I will explore the complexities of applying virtue ethics to clinical life. I argue that the development of virtuous physicians requires everyday clinical encounters, which are like the passage of ordinary time on the church calendar. These intervals become needful spaces for deeper appreciation for and maturation of our conceptions of medicine; for learning to see, understand, and embody goodness. Contrary to expectation, I believe a routine visit with a patient in homeostasis and “not much going on” is a greater challenge for a physician’s practice of virtue than even when that same physician is tasked with caring for a patient in life-threatening circumstances.
Relatedly, I argue that the physician’s opportunity to participate in the formation of her patient’s character occurs most powerfully in the context of everyday medical encounters. Pellegrino and Thomasma identified multiple valences of goodness for physicians to pursue, the highest levels being “the good of the patient as a person” and “the spiritual good of the patient”. It is within our everyday encounters that the pursuit of these goods becomes dialogical between physician and patient, and expands to include social virtues.
The spectrum of medical care spans from crisis to quotidian, and many have rightfully considered the function of virtue in emergent situations. A greater coherence is required as we move from the ICU to the clinic, and the latter's unassuming quality nevertheless is fertile ground for becoming physicians and patients of virtue.