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      Revisiting the need for virtue in medical practice: a reflection upon the teaching of Edmund Pellegrino

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          Abstract

          Edmund Pellegrino considered medicine as a skill, art, and perhaps most importantly, a moral enterprise. In this essay, I attempt to exemplify how the legacy and contributions of Edmund Pellegrino, as a teacher and a physician, could allow for a renaissance of medical practice in which physicians engage intellectual and moral virtue to both effect sound care, and do so in a humanitarian way, rather than in simple accordance with a business model of medicine. The virtues are viewed in a renewed light as being key characteristics of physicians, and important to patient centered care.

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          Professionalism, profession and the virtues of the good physician.

          Edmund Pellegrino (2002)
          The putative loss of professionalism in medicine has of late become of serious concern to practitioners, educators, ethicists and the public. Impassioned pleas for its restitution abound. Serious ethical obligations are linked to the idea of a profession. Yet, most of the definitions have been socio-historical, political or legal. Important as these aspects may be, there is need for a firmly grounded ethical derivation of the moral dimensions of professionalism. This essay undertakes to provide a philosophical grounding for ethically responsible professionalism in the phenomena of clinical medicine, in the character of the professional, and in virtue theory.
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            A virtue ethics approach to moral dilemmas in medicine.

            P Gardiner (2003)
            Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine.
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              Toward a reconstruction of medical morality.

              Edmund Pellegrino (2016)
              At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive--together with the physician--at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.
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                Author and article information

                Contributors
                Luchuo Engelbert Bain:
                ORCID: http://orcid.org/0000-0002-6006-2698
                lebaiins@gmail.com
                Journal
                Journal ID (nlm-ta): Philos Ethics Humanit Med
                Journal ID (iso-abbrev): Philos Ethics Humanit Med
                Title: Philosophy, Ethics, and Humanities in Medicine : PEHM
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1747-5341
                Publication date (Electronic): 10 April 2018
                Publication date PMC-release: 10 April 2018
                Publication date Collection: 2018
                Volume: 13
                Electronic Location Identifier: 4
                Affiliations
                [1 ]Centre for Population Studies and Health Promotion, CPSHP, Yaounde, Cameroon
                [2 ]ISNI 0000 0004 1754 9227, GRID grid.12380.38, Athena Institute for Research on Innovation and Communication in Health and Life Sciences, , Vrije Universiteit Amsterdam, ; Amsterdam, The Netherlands
                Author information
                http://orcid.org/0000-0002-6006-2698
                Article
                Publisher ID: 57
                DOI: 10.1186/s13010-018-0057-0
                PMC ID: 5891999
                PubMed ID: 29631600
                SO-VID: 9fcf6d6a-773f-4b93-a06c-c38ba20ac381
                Copyright © © The Author(s). 2018
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 3 November 2017
                Date accepted : 2 April 2018
                Categories
                Subject: Commentary
                Custom metadata
                issue-copyright-statement © The Author(s) 2018

                ScienceOpen disciplines: Philosophy of science
                Keywords: edmund pellegrino,ethics,morality,virtue,art of medicine
                Data availability:
                ScienceOpen disciplines: Philosophy of science
                Keywords: edmund pellegrino, ethics, morality, virtue, art of medicine

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