‘The best interest of patients, not self-interest’: how clinicians understand altruism

Abstract

Background Altruism refers to acting in ‘the best interest of patients, not self-interest’. With an observed discordance between the concept and practice of altruism, and increasing attention to ‘pathologic altruism’, the role of altruism is blurred in present day medical care. In this background, the required balance of altruistic attitude which needs to be fostered in medical students needs clarity. This problem may be best addressed by the practicing clinicians. The objectives of this study were to explore clinicians’ understanding of altruism in the clinical context and to identify the key concepts of altruism which they felt, must be included in clinical practice. Methods It was an exploratory qualitative study to identify clinicians’ understanding of altruism and the key practice points for altruism. Online semi-structured interviews were conducted from 18 clinicians through Zoom and transcribed using Otter. Open coding of interview transcripts was done using Atlas ti 8 and grouped by commonalities under sub themes and themes. Results The main concepts regarding the clinicians’ understanding of altruism were prioritizing patients’ interest above oneself, favouring patients beyond routine duty and organized team work for practicing altruism. The essential practice areas identified for altruism were finding a balance between altruistic tendency and self/family life, identifying one’s individual capacity for altruism, establishing teamwork for developing a workplace altruistic attitude, and facilitating patients beyond routine duty. Conclusions Altruism is an important professionalism attribute for clinicians, however prioritizing patients interest requires a balanced approach so that it is effective and sustainable. Workplace altruistic cultures may be better promoted through organized team-based approach rather than individual efforts.

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“…Other studies have also found that cultural attitudes about health professionals, and individual professional identities play a role in MJH(Humphrey and Russell 2004;Moghri et al 2022). Although the role of altruism has been described in improving commitment of health workers to their work(Sajjad et al 2021), others have pointed to the reality of meeting family obligations(Lo et al 2018). The study participants highlighted the need to support or meet the expectations of extended family as one of the drivers of MJH.…”

What constitutes altruism in the present medical context?

“…Rather, a more realistic approach to practice altruism requires prioritizing patients' interest but also identifying one's individual capacity and making a conscious effort to balance work-life commitments in this regard. Such a balanced altruistic approach may be more effective and sustainable in the long run (Sajjad et al, 2021).…”

“…This may also include substituting an alternative treatment for patients who can't afford a certain treatment rather than denying it altogether. Promoting a workplace altruistic culture with organized team efforts for altruistic activities based on a commitment to prioritize patients' interest at all times is desirable (Sajjad et al, 2021). This may include activities like generating ward funds for needy patients and having a system of backups in situations where doctors have a personal or family emergency or commitment.…”