Virtue in Emergency Medicine

Abstract

At a time in which the integrity of the medical profession is perceptibly challenged, emergency physicians (EPs) have an opportunity to reaffirm their commitment to both their patients and their practice through acceptance of a virtue-based ethic. The virtue-based ethic transcends legalistic rule following and the blind application of principles. Instead, virtue honors the humanity of patients and the high standards of the profession. Recognizing historical roots that are relevant to the modern context, this article describes 10 core virtues important for EPs. In addition to the long-recognized virtues of prudence, courage, temperance, and justice, 6 additional virtues are offered unconditional positive regard, charity, compassion, trustworthiness, vigilance, and agility. These virtues might serve as ideals to which all EPs can strive. Through these, the honor of the profession will be maintained, the trust of patients will be preserved, and the integrity of the specialty will be promoted. are often linked to malpractice claims, outcome data, economic profiling, and, even more recently, the ability to follow practice guidelines. Although following rules and optimizing technical outcomes are important, they say little about the physician's character. Character, or virtue, is an ancient concept that is often not well articulated in our modern conception of the complete emergency physician (EP). We assert that virtue is central to the practice of emergency medicine (EM) and that there are specific, identifiable virtues that the practitioner should possess. CHARACTER AND VIRTUEEthike, the Greek word for ''character,'' forms the etymological root and philosophical basis of the classical Western notion of ethics. For the ancients, character and virtue were inextricably intertwined. Homer's Iliad contains an early depiction of character (ethike) and virtue (arete). In it, the heroes of the Trojan War are animated by their quest for virtue, or attempts to achieve perfection. Homer used the Greek word arete to describe not only virtue, but all characteristics that enable an individual to achieve excellence in the performance of their duties.The ancient Greek notion of character and virtue was most highly developed by Aristotle around 330 BC. In The Nichomachean Ethics, Aristotle states that the exercise of virtue is necessary to live a good and happy life.1 Virtues are dispositions to be good. They include not only good actions, but also good thoughts and good feelings. Aristotle further described virtue or character as the golden mean between deficiency and excess. Courage, e.g., was described as the mean between foolhardiness and cowardice. Like Socrates and Plato before him, Aristotle regarded courage, justice, prudence, and temperance to be the four cardinal virtues. The struggle for optimal balance in one's life was the struggle for virtue. His concept was that virtue must be practiced to find the balance; it must be cultivated for moral behavior to become a habit. 2,3Virtue-based ethical concepts remained i...

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