Virtual Mentor. April 2001, Volume 3, Number 4.
Is Medical Professionalism Eroding?
Physicians must maintain their professional and ethical duties to patients even in light of health care corporations employing a growing number of physicians.
Keith Bauer, PhD, MSW
In The Remains of the Profession, or What the Butler Knew, the author attempts to answer the above questions by reflecting on the actions of Stevens, the butler in Kazuo Ishiguro's award-winning novel, The Remains of the Day. By way of comparison with Ishiguro's work, the author argues that as physicians lose control over the ends of their work -- patient care and well being -- and disclaim responsibility for the uses to which their work is applied, their professionalism erodes. As their sense of professionalism erodes, physician-employees of health care organizations may identify increasingly with their colleagues and employers, become emotionally disconnected from patients and, worst of all, fail to develop their capacity for individual moral agency. Like Ishiguro's butler, physician-employees may end up only mimicking professionalism as they work for employers who value them only as servants.
Questions for Discussion
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