Journal of Medical Humanities

, Volume 37, Issue 4, pp 419–433 | Cite as

Can Doctors Maintain Good Character? An Examination of Physician Lives

  • Saba FatimaEmail author


Can doctors maintain good character? This paper shifts the focus from patient care to ethical considerations that bear on the physician and impact her as a person. By decentering patient care, the paper highlights certain factors that habituate a particular way of reasoning that is not conducive to inculcating good character. Such factors include, standards of professionalism, being influenced by external monitors, and emphasis on adherence to guidelines. While such factors may benefit patients, they often adversely affect the character of physicians.


Character Physician Professionalism Virtue Empathy Compassion 



I would like to thank Alison Reiheld, PhD. and Erik Krag, PhD. for their constructive feedback on earlier drafts and the invaluable anonymous reviewers for their feedback on the latter versions. This paper also would not have been possible without the indispensable input from Huzaifa Quaizar, MD.


  1. American Academy of Family Physicians. 2013. “Lifestyle & Income for Family Physicians.” Accessed February 15, 2016.
  2. Aristotle. 1989. Nicomachean Ethics. Translated by D. Ross, Rev. J. L. Ackrill & J. O. Urmson. Oxford, UK: Oxford University Press.Google Scholar
  3. Bailey, Alison. 2000. “Locating Traitorous Identities.” In Decentering the Center: Philosophy for a Multicultural, Postcolonial, and Feminist World, edited by Uma Narayan and Sandra Harding, 283-298. Indianapolis, Ind.: University of Indiana Press.Google Scholar
  4. Braddock, C.H., III and L. Snyder. 2005. “The Doctor will see you shortly. The Ethical Significance of Time for the Patient-physician Relationship.Journal of General Internal Medicine 20:1057–62.CrossRefGoogle Scholar
  5. Carse, Alisa L. 2005. “The Moral Contours of Empathy.” Ethical Theory and Moral Practice 8 (1/2): 169-95.CrossRefGoogle Scholar
  6. Castilla, Emilio J., and Stephen Benard. 2010. “The Paradox of Meritocracy in Organizations.” Administrative Science Quarterly 55: 543-576.CrossRefGoogle Scholar
  7. Canale, Del S., D.Z. Louis, V. Maio, X. Wang, G. Rossi, M. Hojat, J.S. Gonnella. 2012. “The Relationship between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and their Diabetic Patients in Parma, Italy.” Academic Medicine 87 (9):1243-9.Google Scholar
  8. DeNavas-Walt, Carmen and Bernadette D. Proctor. 2015. Income and Poverty in the United States: 2014. U.S. Census Bureau. Washington, DC.: U.S. Government Printing Office. Accessed February 15, 2016.
  9. DHS: Department of Health. 2012. “Transforming Care: A National Response to Winterbourne View Hospital, Department of Health Review: Final Report.” Accessed November 1, 2013.
  10. Doris, John. 2002. Lack of character: Personality and moral behavior. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  11. Gallagher, Charles A. 2003. “Color-Blind Privilege: The Social and Political Functions of Erasing the Color Line in Post Race America, Race, Gender & Class.” Privilege and Race, Gender, and Class 10 (4): 22-37.Google Scholar
  12. Gardiner, P. 2003. “A Virtue Ethics Approach to Moral Dilemmas in Medicine.” Journal of Medical Ethics 29:297-302.CrossRefGoogle Scholar
  13. Harman, Gilbert. 1999. “Moral Philosophy meets Social Psychology: Virtue Ethics and the Fundamental Attribution Error.” Proceedings of the Aristotelian Society 99:315-332.CrossRefGoogle Scholar
  14. ———. 2000. “The Nonexistence of Character Traits.” Proceedings of the Aristotelian Society 100: 223-226.Google Scholar
  15. Hojat, Mohammadreza, Michael J. Vergare, Kaye Maxwell, George Brainard, Steven K. Herrine, Gerald A. Isenberg, Jon Veloski, and Joseph S. Gonnella, 2009. “The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School.” Academic Medicine 84 (9): 1182-1191.CrossRefGoogle Scholar
  16. Hursthouse, Rosalind. 1999. On Virtue Ethics. Oxford, UK: Oxford University Press.Google Scholar
  17. Jansen, Lynn A. 2000. “The Virtues in their Place: Virtue Ethics in Medicine.” Theoretical Medicine and Bioethics 21 (3): 261-275.CrossRefGoogle Scholar
  18. Katz, D.A., G.C. Williams, R.L. Brown, T.P. Aufderheide, M. Bogner, P.S. Rahko, and H.P. Selker. 2005. “Emergency Physicians’ Fear of Malpractice in Evaluating Patients with Possible Acute Cardiac Ischemia.” Annals of Emergency Medicine 46 (6): 525-33.CrossRefGoogle Scholar
  19. Kessler, Daniel and Mark McClellan. 1996. “Do Doctors Practice Defensive Medicine?” The Quarterly Journal of Economics 111 (2): 353-390.CrossRefGoogle Scholar
  20. Kraus M.W. and D. Keltner. 2013. “Social Class Rank, Essentialism, and Punitive Judgment.” Journal of Personality and Social Psychology 105 (2): 247-61.CrossRefGoogle Scholar
  21. Lelorain, S., A. Dolbeault Brédart, and S. Sultan. 2012. “A Systematic Review of the Associations between Empathy Measures and Patient Outcomes in Cancer Care.” Psycho-Oncology 21:1255–1264.CrossRefGoogle Scholar
  22. Linzer M., T.R. Konrad, J. Douglas, et al. 2000. “Managed Care, Time Pressure, and Physician Job Satisfaction: Results from the Physician Worklife Study.” Journal of General Internal Medicine 15:441–50.CrossRefGoogle Scholar
  23. MacIntyre, Alasdair. 2007. After Virtue. Notre Dame, IN: University of Notre Dame, 3rd Edition.Google Scholar
  24. Maslach, C., and M.P. Leiter. 1997. The Truth about Burnout. San Francisco: Jossey Bass.Google Scholar
  25. Maslach, C., S.E.Jackson, and M.P. Leiter. 1996. MBI: The Maslach Burnout Inventory Manual. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  26. Medical Group Management Association Survey. 2013. “Physician Compensation includes Quality and Patient Satisfaction Components.” Accessed February 15, 2016.
  27. Mello, Michelle M., Emily R. Carrier, James D. Reschovsky, David A. Katz. 2013. “High Physician concern about Malpractice Risk predicts more Aggressive Diagnostic Testing In Office-Based Practice.” Health Affairs 32:1383-1391.CrossRefGoogle Scholar
  28. Miller, Christian. 2009. “Empathy, Social Psychology, and Global Helping Traits.” Philosophical Studies: An International Journal for Philosophy in the Analytic Tradition 142 (2): 247-275.CrossRefGoogle Scholar
  29. Montgomery, Kathryn. 2005. How Doctors Think: Clinical Judgment and the Practice of Medicine. New York, NY: Oxford University Press.Google Scholar
  30. Morse, Diane, Elizabeth Edwardsen, and Howard Gordon. 2008. “Missed Opportunities for Interval Empathy in Lung Cancer Communication.” Archives of Internal Medicine 168 (17): 1853-1858.CrossRefGoogle Scholar
  31. Neumann, Melanie. Friedrich Edelhäuser, 2011. “With Medical Students and Residents.” Academic Medicine 86 (8): 996-1009.Google Scholar
  32. Pellegrino, Edmund D. 2008 (1995). The Philosophy of Medicine Reborn: A Pellegrino Reader. Notre Dame, IN: University of Notre Dame.Google Scholar
  33. Pellegrino, Edmund D., and David C. Thomasma. 1993. The Virtues in Medical Practice. New York City, NY: Oxford University Press.Google Scholar
  34. Piper, Adrian. 1991. “Impartiality, Compassion, and Modal Imagination.” Ethics 101 (4): 726–57.CrossRefGoogle Scholar
  35. Putman, D.A. 1988. “Virtue and the Practice of Modern Medicine.” The Journal of Medicine and Philosophy 13 (4):433-43.CrossRefGoogle Scholar
  36. Reverby. Susan M. 2012. “Ethical Failures and History Lessons: The U.S. Public Health Service Research Studies in Tuskegee and Guatemala.” Public Health Reviews 34 (1): 1-18.Google Scholar
  37. Rosen, Ilene M., Phyllis A. Gimotty, Judy A. Shea, and Lisa Bellini. 2006. “Duty Hours: Evolution of Sleep Quantity, Sleep Deprivation, Mood Disturbances, Empathy, and Burnout among Interns.” Academic Medicine 81 (1): 82-85.CrossRefGoogle Scholar
  38. Saitta, Nicole and Samuel D. Hodge. 2012. “Efficacy of a Physician’s Words of Empathy: An Overview of State Apology Laws.” Journal of the American Osteopathic Association 112 (5): 302-306.CrossRefGoogle Scholar
  39. Sartre, Jean-Paul. 1995 (1948). Anti-Semite and Jew: An Exploration of the Etiology of Hate. New York City, NY: Schocken.Google Scholar
  40. Schaufeli, W. B., and E. R.Greenglass, 2001. “Introduction on a Special Issue on Burnout and Health.” Psychology & Health 16: 501-510.Google Scholar
  41. Shanafelt T, J. Sloan, and T. Habermann. 2003. “The Well-being of Physicians.” American Journal of Medicine 114 (6): 513–519.CrossRefGoogle Scholar
  42. Shanafelt T.D., S. Boone, L. Tan, et al. 2012. “Burnout and Satisfaction with Work-Life Balance among U.S. Physicians relative to the general U.S. Population. Archives of Internal Medicine 172 (18): 1377-1385.CrossRefGoogle Scholar
  43. Snow, Nancy. 2000. “Empathy.” American Philosophical Quarterly 37 (1): 65–78.Google Scholar
  44. Stepien, K.A., and A. Baernstein. 2006. “Educating for Empathy. A Review.” Journal of General Internal Medicine 21 (5): 524–530.CrossRefGoogle Scholar
  45. Studdert, David M., Michelle M. Mello, William M. Sage, Catherine M. DesRoches, Jordon Peugh, Kinga Zapert, and Troyen A. Brennan. 2005. “Defensive Medicine among High-risk Specialist Physicians in a Volatile Malpractice Environment.” Journal of the American Medical Association, 293 (21): 2609-2617.CrossRefGoogle Scholar
  46. Thomas, Matthew R., Liselotte N. Dyrbye, Jefrey L. Huntington, Karen L. Lawson, Paul J. Novotny, Jeff A. Sloan, and Tait D. Shanafelt. 2007. “How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study.” Journal of General Internal Medicine 22 (2): 177–183.CrossRefGoogle Scholar
  47. Vaughn, Bryan T., Steven R. DeVrieze, Shelby D. Reed, and Kevan A. Schulman. 2010. “Can we close the Income and Wealth Gap between Specialists and Primary Care Physicians?” Health Affairs 29 (5): 933-940.CrossRefGoogle Scholar
  48. West, Colin P. Angelina D. Tan, Thomas M. Habermann, Jeff A. Sloan, and Tait D. Shanafelt. 2009. “Resident Fatigue and Distress with perceived Medical Errors.” Journal of the American Medical Association 302 (12): 1294-1300.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Philosophy DepartmentSouthern Illinois University EdwardsvilleEdwardsvilleUSA

Personalised recommendations