Transcript Professionalism

This material is presented to first
year medical students prior to
small group sessions in which
they develop their own version of
the Hippocratic Oaths. For
further information contact
[email protected].
Oaths:The Hippocratic
Tradition
Lois LaCivita Nixon, PhD, MLitt, MPH
College of Medicine
University of South Florida
Purpose of Class
• To review characteristics associated with the
medical profession. (theology, medicine, and law:
the “learned” professions)
• To consider the symbolic nature of an oath,
specifically the Hippocratic Oath, USF’s revised
version, and excerpts from various other oaths.
• To meet in small groups to draft a
“working declaration, affirmation, or
oath” for presentation at the White
Coat Ceremony.
Professionalism
Seven characteristics described
by Abraham Flexner in 1910.
His report (Flexner Report) led to the
standardization of medical education.
Considered to be the most important
change event in modern medicine.
Characteristics
-Flexner-
1. Essentially intellectual—or “learned”
2. Special body of knowledge
continuously expanded by research
3. Practical end (service)
4. Specialized training of techniques
Characteristics
-Flexner-
5. Moral commitment, a brotherhood (sic)
6. Self-organization and self-regulation
7. Altruistic motivations (unselfish regard
for welfare of others)
Project Professionalism: ABIM
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ALTRUISM
DUTY
EXCELLENCE
HONOR
• INTEGRITY
• ACCOUNTABILITY
• RESPECT FOR
OTHERS
John Stone, MD, cardiologist, poet
For the heart will lead
For the head will explain
but the final common pathway is the heart
whatever kingdom may come
For what matters finally is how the human spirit is
spent.
In recent years additional attention has been
given to the following concerns:
•Just distribution of finite resources
•Maintenance of trust by managing
• conflict of interest
•Improved access
These suggest a shift from physician-to-patient
and patient-to-physician concerns to a broader
physician-to-society focus.
Class of 2006
integrity
communicator
committed to learning
open/honest
humility
respect/courtesy generosity of spirit
competent
empathy
accountability
listener
considerate
confidentiality
non-condescending
maturity
tolerance for difference
teaching skills
culturally sensitive
humor
current knowledge
Bonding Declarations/
Commitments
• Promises
• Codes
• Oaths
Oaths
• Performative
utterance (before
others)
• Solemn declaration
• Extended timeframe (or
lifetime)
• Validated by
transcendent appeal,
something sacred
• Involves relationships
with other
• Moral weight, never
trivial
and………..
•Proscribes consequences for failure
Cross my heart and hope to die……..
Oath breaker?!
Curtains!!
Examples or illustrations of the range of sworn oaths:
I swear…
I solemnly declare…
I hold these truths…
The Oath of the Horatii by David (French painter)
Maimonides, Rabbi, Physician, Philosopher
RaMBaM, 1135-1204
Mecca
On my honor, I will do my duty to God and my
Country….
Consecration of Bishops
West Point
So help me God….
Film excerpt
Extreme Measures
Two physicians
*Hugh Grant…good
*Gene Hackman…bad
•An oath is not universal, it is not a legal obligation,
and it does not guarantee morality.
•Affirmations work to strengthen resolve to behave with
integrity in extreme circumstances.
•An oath encourages examination of core values.
•An oath is a declaration of commitment and intention.
College of Medicine Graduation
Film clip: Extreme Measures (Gene Hackman
as arrogant physician who uses homeless and
others to harvest organs for more “worthwhile”
members of society. Hugh Grant provides the
challenge)
http://hscvideo2.hsc.usf.edu/asxroot/hsc/jkeats
/xmeasure.asx
Life is short, the art of medicine is long,
experience difficult.
NEXT
Apollo, Dionysus, Proteus
The Staff of Aesculapius
Slides
Film Excerpt
Small Group
Discussion