Abstract
During the four decade span of my career medicine has changed dramatically. Regrettably my generation of physicians has been party to the evolving prioritization of profit over principle that has characterized those years. We have been indoctrinated into the commercial ethic, and in the process have lost professional autonomy and agency. The greed of some doctors (“knaves”) and the complacency of many more (“pawns”) have abetted the advancing power of the medical marketplace. Ethics for some has become functionally irrelevant. Those few physicians who resist these trends (“knights”) have insufficient strength to prevail, and become disposable as today’s “sacrificial lambs”. Medicine is thriving as a business, but will it survive as a profession? The heroics of so many HCPs during the COVID-19 pandemic suggest that it can. We must support the next generation of doctors and nurses to follow their stellar example. Society also should emphasize the importance of simple, genuine caring for our patients and each other. Devotion to the time and quality of care necessary for medical professionalism merits support. Public health, the target of humanitas and misericordia, demands no less.
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Notes
- 1.
Addressing medical rationing in 1997, my mentor, Professor Mark Hall wrote, “Medical ethics is subservient to the financing system within which society asks physicians to practice.” At the time he was referring to physicians’ responsibility to distributive justice and their need to conserve limited resources not only for their individual patients, but also for society at large. In the present context that statement becomes much more ominous (Italics added).
- 2.
The medical narrative also is pursued in the journal, Narrative Inquiry in Bioethics, edited by James DuBois, D.Sc., Ph.D.; and Ana Iltis, Ph.D. Its second issue (2011) was devoted to physicians’ stories of the influence of financial conflicts of interest upon their training or practice.
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Lemley, D.E. (2022). An Uncertain Future for Medicine: Business or Profession?. In: Too Conscientious: The Evolution of Ethical Challenges to Professionalism in the American Medical Marketplace. The International Library of Bioethics, vol 94. Springer, Cham. https://doi.org/10.1007/978-3-030-96859-5_13
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