150 research outputs found
Valuing virtue in medicine: a closer look at CanMEDS
No full textAbstract
The CanMEDS-2015 Framework outlines seven key roles expected of practicing physicians: communicator, collaborator, manager, health advocate, scholar, and professional. Critics have expressed concern about the omission of a proposed eighth role, ‘Physician as Person’ relevant to humane qualities and personal resilience of the physician. Upon further analyses, the Framework has included several virtuous attributes in the roles of a physician as professional and communicator. However, it addresses certain virtues like creativity, love, and spirituality inadequately. Drawing on literature from Positive Psychology, the author categorizes and additional set of virtues into six classes: wisdom, courage, humanity, justice, temperance, and transcendence. Based on these, the author lists virtues and concepts relevant to a ‘Virtuous Role’ for physicians. The CanMEDS Framework should integrate these virtues as a foundational or overarching role and draw from Virtue Ethics in religious and philosophical traditions. This approach is timely, giving ongoing efforts to update and develop CanMEDS2025. By adopting a Virtuous Role within CanMEDS, we aim to train physicians who are technically skilled and deeply humane, meeting society's expectations for compassionate and virtuous healthcare professional
Conceptualising population health: from mechanistic thinking to complexity science
No full textAbstract The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS). The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.</p
Valoriser la vertu en médecine : un examen plus approfondi de CanMEDS
No full textThe CanMEDS-2015 Framework outlines seven key roles expected of practicing physicians: communicator, collaborator, manager, health advocate, scholar, and professional. Critics have expressed concern about the omission of a proposed eighth role, ‘Physician as Person’ relevant to humane qualities and personal resilience of the physician. Upon further analyses, the Framework has included several virtuous attributes in the roles of a physician as professional and communicator. However, it addresses certain virtues like creativity, love, and spirituality inadequately. Drawing on literature from Positive Psychology, the author categorizes and additional set of virtues into six classes: wisdom, courage, humanity, justice, temperance, and transcendence. Based on these, the author lists virtues and concepts relevant to a ‘Virtuous Role’ for physicians. The CanMEDS Framework should integrate these virtues as a foundational or overarching role and draw from Virtue Ethics in religious and philosophical traditions. This approach is timely, giving ongoing efforts to update and develop CanMEDS2025. By adopting a Virtuous Role within CanMEDS, we aim to train physicians who are technically skilled and deeply humane, meeting society\u27s expectations for compassionate and virtuous healthcare professionalsLe cadre CanMEDS-2015 décrit sept rôles clés attendus des médecins en exercice : communicateur, collaborateur, gestionnaire, promoteur de la santé, érudit et professionnel. Des critiques ont exprimé leurs préoccupation quant à l\u27omission d\u27un huitième rôle proposé, « le médecin en tant que personne », qui concerne les qualités humaines et la résilience personnelle du médecin. Après une analyse plus approfondie, le cadre inclus plusieurs attributs vertueux dans les rôles du médecin, en tant que professionnel et communicateur. Toutefois, il n\u27aborde pas suffisamment certaines vertus, telles que la créativité, l\u27amour et la spiritualité. S\u27appuyant sur la littérature en psychologie positive, l\u27auteur propose un ensemble supplémentaire de vertus classées en six catégories : sagesse, courage, humanité, justice, tempérance et transcendance. Sur cette base, l\u27auteur dresse une liste de vertus et de concepts pertinents pour un « rôle vertueux » des médecins. Le cadre CanMEDS devrait intégrer ces vertus en tant que rôle fondamental ou primordial et s\u27inspirer de l\u27éthique de la vertu issu des traditions religieuses et philosophiques. Cette approche est opportune, compte tenu des efforts actuels de mise à jour et de développement de CanMEDS2025. En adoptant un rôle vertueux au sein du cadre CanMEDS, nous visons à former des médecins techniquement compétents et profondément humains, répondant ainsi aux attentes de la société en faveur de professionnels de santé compatissants et vertueux
The 12 dimensions of health impacts of war (the 12-D framework): a novel framework to conceptualise impacts of war on social and environmental determinants of health and public health
No full textGlobal rates of armed conflicts have shown an alarming increase since 2008. These conflicts have devastating and long-term cumulative impacts on health. The overriding aim in these conflicts is to achieve military or political goals by harming human life, which is the antithesis of the moral underpinnings of the health professions. However, the profession has rarely taken on a global advocacy role to prevent and eliminate conflicts and wars. To assume such a role, the health profession needs to be aware of the extensive and multiple impacts that wars have on population health. To facilitate this discourse, the author proposes a novel framework called ‘The Twelve Dimensions of Health Impacts of War’ (or the 12-D framework). The framework is based on the concepts of social and environmental determinants of population health. It has 12 interconnected ‘dimensions’ beginning with the letter D, capturing the adverse impacts on health (n=5), its social (n=4) and environmental determinants (n=3). For health, the indices are Deaths, Disabilities, Diseases, Dependency and Deformities. For social determinants of health, there are Disparities in socioeconomic status, Displacements of populations, Disruptions to the social fabric and Development reversals. For environmental determinants, there is Destruction of infrastructure, Devastation of the environment and Depletion of natural resources. A relatively simple framework could help researchers and lay public to understand the magnitude and quantify the widespread health, social and environmental impacts of war, comprehensively. Further validation and development of this framework are necessary to establish it as a universal metric for quantifying the horrific impacts of war on the planet and garner support for initiatives to promote global peace
Poverty, inequality and health: issues relevant to South Asia
No full textemphasised the situation of poverty and health in South Asia [1]. The region has half the population below the poverty line and burdens from communicable and noncommunicable diseases, injuries, tobacco use and malnutrition. It is also the “the poorest, most illiterate, most malnourished, least gender-sensitive and most deprived region of the world ” [2]. The article gives an overview of a few selected areas related to poverty, inequality and ill health, which are especially relevant to health workers in southern Asia. What is poverty? The simplest definition of the poor is “having little money or means ” [3]. However, poverty has several facets such as social exclusion and low self-esteem, though the emphasis is often on money, materials or assets. Relativ
Faith-Based NGOs and Healthcare in Poor Countries: A Preliminary Exploration of Ethical Issues
No full textAn increasing number of non-governmental organisations (NGOs) provide humanitarian assistance, including healthcare. Some faith-based NGOs combine proselytising work with humanitarian aid. This can result in ethical dilemmas that are rarely discussed in the literature. The article explores several ethical issues, using four generic activities of faith-based NGOs: (1) It is discriminatory to deny aid to a needy community because it provides less opportunity for proselytising work. Allocating aid to a community with fewer health needs but potential for proselytising work is unjust, since it neither maximises welfare (utilitarianism) nor assists the most needy (egalitarianism). (2) Faith-based-NGOs may state that proselytising work combined with humanitarian assistance improves spiritual wellbeing and overall benefit. However, proselytising work creates religious doubts, which could transiently decrease wellbeing. (3) Proselytising work is unlikely to be a perceived need of the population and, if carried out without consent, breaches the principle of autonomy. Such work also exploits the vulnerability of disaster victims. (4) Governments that decline the assistance of a faith-based NGO involved in proselytising work may deprive the needy of aid. Three strategies are proposed: (a) Increase knowledge to empower communities, individuals and governments; information on NGOs could be provided through an accessible register that discloses objectives, funding sources and intended spiritual activities. (b) Clearly demarcate between humanitarian aid from proselytising work, by setting explicit guidelines for humanitarian assistance. (c) Strengthen self-regulation by modifying the Code of Conduct of the Red Cross to state criteria for selecting communities for assistance and procedures for proselytising work
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