{"id":4340,"date":"2022-10-10T03:47:58","date_gmt":"2022-10-10T02:47:58","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4340"},"modified":"2022-10-10T03:47:58","modified_gmt":"2022-10-10T02:47:58","slug":"making-sense-of-value-conflicts-at-the-margins-of-the-medical-profession","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/10\/10\/making-sense-of-value-conflicts-at-the-margins-of-the-medical-profession\/","title":{"rendered":"Making sense of value conflicts at the margins of the medical profession"},"content":{"rendered":"<p>By Henk Jasper van Gils-Schmidt and Sabine Salloch<\/p>\n<p>In our paper, \u201cTaking a Moral Holiday? Physicians\u2019 practical identities at the margins of professional\u00a0ethics\u201d, we discuss value conflicts that physicians come across at the margins of their professional practice. For example, the conflict one may experience as a psychiatrist when considering to speak out against a public figure about a suspected mental disease or the question whether one, as a physician, is always obliged to diagnose and treat family members and friends (apart from emergency situations). By introducing the theory of Christine M. Korsgaard, which centers around the concept of practical identity, we illustrate three main types of such conflicts \u201cat the margins\u201d that occur in the intersection between professional ethics and moral demands originating from other sources. We identify either how such conflicts can be solved or how the emotional and moral burden can be explained by framing them in terms of conflicts between practical identities. We furthermore point out that prominent theories of professional ethics \u2013 e.g., the reference to an internal morality of medicine, contractualism or theories of supererogation \u2013 are less suitable for such sense-making activity on the edge of physicians\u2019 job activities.<\/p>\n<p>We felt the need to explore a different way, a different theoretical outlook, to make sense of such value conflicts, because although they are \u201cmerely\u201d at the margins of the profession, they are often central to the life of doctors and other medical professionals. One such example is of medical staff that stayed in hotel rooms during the uncertain times at the start and middle of the pandemic as not to infect and be a danger to their family at home. Other situations refer to physicians\u2019 commitment to sustainability that can run into conflict with high-quality patient care. How can we make sense from a theoretical point of view from such conflicts that are experienced as very pressing? To what extend can codes of professional ethics still maintain authority if they come into conflict with deeply felt non-professional moral obligations? And how can theory help us to understand and deal with such value conflicts as they occur in our lives?<\/p>\n<p>Exploring potential answers to these questions motivated our paper. We chose an ethical approach that puts the idea of \u201cwhat we value in ourselves\u201d central to its theoretical foundations. In this way, we were able to conceptualize the conflicts that occur at the margins of the medical profession \u2013 which we interpret as conflicts between different values that give a sense of purpose to a person\u00b4s life \u2013 and discuss potential ways of dealing, or making sense of, such conflicts. We found that our intuitions in this regard where resonated both in teaching classes for medical students \u2013 who were able to quickly pick up the notion of \u201cpractical identities\u201d and apply them to situations \u2013as well as in situations experienced by ourselves, e.g. as a mother and medical ethicist in dealing with the 8 year old son becoming a research subject.<\/p>\n<p>&nbsp;<\/p>\n<p>Paper title: <a href=\"https:\/\/jme.bmj.com\/content\/early\/2022\/09\/29\/jme-2022-108500\">Taking a Moral Holiday? Physicians\u2019 practical identities at the margins of professional\u00a0ethics<\/a><\/p>\n<p>Authors: Henk Jasper van Gils-Schmidt<sup>1<\/sup> and Sabine Salloch<sup>2<\/sup><\/p>\n<p>Affiliations:<\/p>\n<p>1) Department of Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany;<\/p>\n<p>2) Institute of Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany<\/p>\n<p>Competing interests: We have no competing interests to declare.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Henk Jasper van Gils-Schmidt and Sabine Salloch In our paper, \u201cTaking a Moral Holiday? Physicians\u2019 practical identities at the margins of professional\u00a0ethics\u201d, we discuss value conflicts that physicians come across at the margins of their professional practice. For example, the conflict one may experience as a psychiatrist when considering to speak out against a [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/10\/10\/making-sense-of-value-conflicts-at-the-margins-of-the-medical-profession\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":353,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[968,8057,2745],"tags":[],"class_list":["post-4340","post","type-post","status-publish","format-standard","hentry","category-clinical-ethics","category-medical-ethics","category-professionalism"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Making sense of value conflicts at the margins of the medical profession - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/10\/10\/making-sense-of-value-conflicts-at-the-margins-of-the-medical-profession\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Making sense of value conflicts at the margins of the medical profession - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Henk Jasper van Gils-Schmidt and Sabine Salloch In our paper, \u201cTaking a Moral Holiday? 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