Understanding Medical Professionalism


Book Description

A groundbreaking text on how to deliver the highest quality patient care through professionalism in daily medical practice Five Star Doody’s Review: “This is an outstanding book for all clinicians and professors, indeed for everyone in medicine to help mentor and self-police the medical profession.” "Understanding Medical Professionalism is a 'must-have' for all involved in the healing arts. The book demystifies professionalism, bringing it from a philosophical, mystical concept to a practical everyday set of behaviors. The twelve chapters, in a uniform way, provide wonderful, real-life stories that illustrate the challenges faced by practitioners, describe ways to deal with those challenges, and help develop the personal and institutional skills necessary to provide excellent and compassionate care." -- Carlos A. Pellegrini, MD, FACS, FRCSI (Hon.), The Henry N. Harkins Professor and Chair, Department of Surgery, University of Washington "Insightful, practical, and authoritative. Building on their own research and that of others, Levinson et al. offer a comprehensive discussion of medical professionalism from the refreshing perspective of behavioral skills and an enabling healthcare system. Understanding Medical Professionalism has fundamentally reframed the professionalism debate and will likely remain the definitive work in this field for quite some time." -- David G. Nichols, MD, President and CEO, The American Board of Pediatrics "The authors' ambitious goal of providing a framework for the continuum of physician development of professional behaviors, from student through expert senior clinician, has been met. Students will find the text modular and instructive; residents will benefit from the reinforcement of positive professional behaviors and explication of strategies to excel in this competency; educational program directors will find the framework and tools for assessment and strategies for remediation enriching; and the expert professional will find subtle opportunities to grow to mastership of this most important physician competency." -- Thomas J. Nasca, MD, MACP, Chief Executive Officer, Accreditation Council for Graduate Medical Education, Professor of Medicine, Jefferson Medical College "The authors offer a framework and an approach to medical professionalism that enable us to understand it, teach it, and incorporate it into our day-to-day lives as health professionals. It is a much needed addition to our armamentarium as we work to align the education of health professionals with the needs and expectations of the society we serve." -- George E. Thibault, MD, President, Josiah Macy Jr. Foundation




Moral Resilience


Book Description

Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish that occurs when the burdens of treatment appear to outweigh the benefits; scarce human and material resources must be allocated; informed consent is incomplete or inadequate; or there are disagreements about goals of treatment among patients, families or clinicians. Each is a source of moral adversity that challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. If moral suffering is unrelieved it can lead to disengagement, burnout, and undermine the quality of clinical care. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. It is vital to shift the focus to solutions and to expanded individual and system strategies that mitigate the detrimental effects of moral suffering. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self-regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.




Code of Ethics for Nurses with Interpretive Statements


Book Description

Pamphlet is a succinct statement of the ethical obligations and duties of individuals who enter the nursing profession, the profession's nonnegotiable ethical standard, and an expression of nursing's own understanding of its commitment to society. Provides a framework for nurses to use in ethical analysis and decision-making.







Conscientious Objection in Health Care


Book Description

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care.




For-Profit Enterprise in Health Care


Book Description

"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.




Fostering Integrity in Research


Book Description

The integrity of knowledge that emerges from research is based on individual and collective adherence to core values of objectivity, honesty, openness, fairness, accountability, and stewardship. Integrity in science means that the organizations in which research is conducted encourage those involved to exemplify these values in every step of the research process. Understanding the dynamics that support â€" or distort â€" practices that uphold the integrity of research by all participants ensures that the research enterprise advances knowledge. The 1992 report Responsible Science: Ensuring the Integrity of the Research Process evaluated issues related to scientific responsibility and the conduct of research. It provided a valuable service in describing and analyzing a very complicated set of issues, and has served as a crucial basis for thinking about research integrity for more than two decades. However, as experience has accumulated with various forms of research misconduct, detrimental research practices, and other forms of misconduct, as subsequent empirical research has revealed more about the nature of scientific misconduct, and because technological and social changes have altered the environment in which science is conducted, it is clear that the framework established more than two decades ago needs to be updated. Responsible Science served as a valuable benchmark to set the context for this most recent analysis and to help guide the committee's thought process. Fostering Integrity in Research identifies best practices in research and recommends practical options for discouraging and addressing research misconduct and detrimental research practices.




Tracking the Care of Patients with Severe Chronic Illness


Book Description

This Atlas builds on the analyses presented in the 2006 edition. As before, the focus is on Medicare beneficiaries who had severe chronic illnesses and were in their last two years of life. This edition both updates the earlier analyses to encompass more recent data (through 2005) and expands the scope to include all sectors of care covered by the Medicare program. This Atlas also proposes new ways of thinking about how to achieve better care coordination and reduce the overuse of acute care hospital services. It offers concrete recommendations on the ways different stakeholders can use the new data - from choosing the right provider to reforming the U.S. health care system.




Handbook of Research Ethics and Scientific Integrity


Book Description

This handbook is a ‘one-stop shop’ for current information, issues and challenges in the fields of research ethics and scientific integrity. It provides a comprehensive coverage of research and integrity issues, both within researchers’ ‘home’ discipline and in relation to similar concerns in other disciplines. The handbook covers common elements shared by disciplines and research professions, such as consent, privacy, data management, fraud, and plagiarism. The handbook also includes contributions and perspectives from academics from various disciplines, treating issues specific to their fields. Readers are able to quickly source the most comprehensive and up-to-date information, protagonists, issues and challenges in the field. Experienced researchers keen to assess their own perspectives, as well as novice researchers aiming to establish the field, will equally find the handbook of interest and practical benefit. It saves them a great deal of time in sourcing the disparate available material in these fields and it is the first ‘port of call’ for a wide range of researchers, research advisors, funding agencies and research reviewers.The most important feature is the handbook’s ability to provide practical advice and guidance to researchers in a wide range of disciplines and professions to help them ‘think through’ their approach to difficult questions related to the principles, values and standards they need to bring to their research practice.




Professionalism and Ethics in Medicine


Book Description

Professionalism and Ethics in Medicine: A Study Guide for Physicians and Physicians-in-Training is a unique self-study guide for practitioners and trainees covering the core competency areas of professionalism, ethics, and cultural sensitivity. This novel title presents real-world dilemmas encountered across the specialties of medicine, offering guidance and relevant information to assist physicians, residents, and medical students in their decision-making. The text is divided into two parts: Foundations and Questions with Answers. The first part provides a substantive foundation of knowledge in the principles, scholarship, policy guidelines, and decision-making strategies of the modern health professions. The second part assists practitioners and trainees in preparing for the complex issues that arise each day in the settings where health professionals work and train – clinics, research centers, educational contexts, and communities. Developed by renowned leaders in a broad range of clinical fields, Professionalism and Ethics in Medicine: A Study Guide for Physicians and Physicians-in-Training is a major, invaluable contribution to the literature and an indispensable reference for clinicians at all levels.