A Piece of My Mind Section Editor: Roxanne
K. Young, Associate Editor.
I would like to offer a simple formula that physicians can readily apply
to act humanistically when faced with moral dilemmas in medical practice that
they do not know how to handle. Since this formula really is quite simple,
I am hoping those who use it will be able to pass it on to their students,
residents, and colleagues and thereby enhance humanism in medicine, even under
the modern pressures of cost containment, managed care, and other forces.
The 20-year tale of my search for this simple moral rule or formula
is itself instructive and dates back to the wonderful opportunity I had to
study moral philosophy for a couple of years between college and medical school.
With that academic background, I arrived at medical school knowing a lot about
what all the great thinkers thought about questions of right and wrong, and
I was conversant in a host of theoretical frameworks and models for moral
decision making. But I obviously did not know the first thing about the practical
side: how to put all of this theory into practice. So in my first year of
medical school, I went around to some of the most distinguished professors
of medicine I could find, asking them what framework or rule they applied
when faced with some moral dilemma in medicine. Most of them replied to me
in the same way, saying something like, "What the heck are you talking about?"
Hundert EM. A Golden Rule: Remember the Gift. JAMA. 2001;286(6):648-650. doi:10.1001/jama.286.6.648