The Role of Virtues in the Practice of Clinical Medicine

By James A. Marcum.

Published by The International Journal of Science in Society

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Article: Electronic $US5.00

I propose a philosophical notion of virtuous physician to address the quality-of-care and professionalism crises plaguing modern western medicine. To that end, I first explore the two crises and contemporary efforts to resolve them. I then discuss virtue theory and the ontological priority of caring, as the chief metaphysical virtue for practicing clinical medicine. I examine two essential metaphysical virtues: care and competence. For clinicians to be competent in medical practice, they must be genuinely caring (as an ontological attitude); because by caring clinicians care₁ deeply enough to be technically and ethically competent, which in turn allows them to care₂ for the patient’s bodily and existential needs and to care₂ about the patient qua person. I next utilize virtue epistemology, in terms of reliabilist and responsibilist intellectual virtues, to explicate technical competence. The virtue of competence is necessary for grounding clinical right actions (ethical competence). I then employ virtue ethics to analyze the practice of clinical medicine. Particularly, the notions of ethical competence and of care₂ are discussed and expounded upon in terms of right action. Although caring (if limited to care₁) is inadequate to choose the right course of clinical action, combined with the virtue of technical and ethical competence and with the ethical virtue of care₂ it is not only adequate but also represents the best means for making right clinical decisions. Finally, I discuss how these virtues address the quality-of-care and professionalism crises. Specifically, I examine how these virtues can be used to reform the paternalistic patient-physician relationship. That reformation depends on the conversion of competence into both theoretical and practical wisdom and on the transformation of care into compassionate empathy or love.

Keywords: Clinical Medicine, Quality-of-Care Crisis, Professionalism Crisis, Virtues, Care, Competence

The International Journal of Science in Society, Volume 1, Issue 3, pp.91-98. Article: Print (Spiral Bound). Article: Electronic (PDF File; 1.684MB).

James A. Marcum

Professor, Department of Philosophy, Baylor University, Waco, Texas, USA