Junior doctors and moral exploitation

Abstract

In this paper I argue that junior doctors are morally exploited. Moral exploitation occurs where an individual’s vulnerability is used to compel them to take on additional moral burdens. These might include additional moral responsibility, making weighty moral decisions and shouldering the consequent emotions. Key to the concept of exploitation is vulnerability and here I build on Rosalind McDougall’s work on the key roles of junior doctors to show how these leave them open to moral exploitation by restricting their reasonable options. I argue that there are a number of ways junior doctors are morally exploited. First, their seniors can leverage their position to force a junior to take on some discreet decision. More common is the second type of moral exploitation where rota gaps and staffing issues means junior doctors take on more than their fair share of the moral burdens of practice. Third, I discuss structural moral exploitation where the system offloads moral burdens onto healthcare professionals. Not every instance of exploitation is wrongful and so I conclude by exploring the ways that moral exploitation wrongs junior doctors.

Junior doctors and conscientious objection to voluntary assisted dying: ethical complexity in practice

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“…Of the constraints on the agency of junior doctors due to their position in the medical hierarchy, Parker notes that ‘[t]he gradient of the hierarchy alone makes it difficult for them to refuse [seniors’ requests] and their reliance on seniors for support, mentorship and education intensifies this’. 44 …”

Operationalizing the role of the nurse ethicist: More than a job

“…Others have argued that healthcare professionals in the UK are currently being morally exploited because of the structural injustices forcing them to bear avoidable moral burdens which would be relieved if the political climate and system were different. 71 Another opportunity to impact policy is by elevating concerns about the widespread creation of policies that are founded on an incomplete understanding of the issue. For example, research about the impact of resilience on moral distress is inconclusive and yet it is promoted as a strategy for addressing moral distress.…”

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“…Parker takes the concept of moral exploitation and uses it to illuminate the position of junior doctors in the medical hierarchy and health system. 2 Hanna and Robert argue that the concept of dignity is an important lens through which to view practices of limb disposal, in the wake of a recent UK scandal in which patients' amputated body parts were stockpiled. 3 Ethical concepts are also central to the argument put forward by Finlay, Choong and Nimmagadda in their analysis of UNESCO's Undergraduate Bioethics Integrated Curriculum.…”