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Presented By: Center for Bioethics and Social Sciences in Medicine (CBSSM)

“When Duty Calls, Hang Up: The Ethics of Quitting for Clinicians”

Erica Andrist, MD

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Abstract: The “Great Resignation” following the SARS-CoV-2 pandemic has not spared the health sector. Resultant staffing shortages have compromised patient safety. The pandemic simultaneously reinvigorated discussions of the clinician’s “duty to care”, a unique ethical and legal responsibility that requires clinicians to place the needs of patients above their own interests. If a strong duty to care exists, then quitting cannot be ethical; however, this also renders clinicians infinitely exploitable by institutions and, to a lesser degree, by patients. This project evaluated the history and ethical underpinnings of the duty to care in the literature, finding general agreement about the existence of a duty to care, but debate over its ethical justification and the limits of the risks a clinician must incur in pursuit of fulfilling the duty. Subsequently, thematic analysis of semi-structured interviews with clinicians who quit their jobs during the pandemic demonstrated that clinicians balance multiple competing duties with the duty to care, including duties to the self, family, colleagues, and health trainees. Being unable to effectively fulfill a perceived duty to patients because of institutional or other constraints also contributed to clinicians’ decision to quit. Additionally, participants expected basic safety measures and fair compensation in return for their service. These findings indicate that clinicians accept a general duty to care, but do not believe that it universally trumps other moral duties. Additionally, reported institutional constraints on good patient care and clinicians’ expectations of basic protections suggest that a corresponding institutional duty to care exists. Future scholarship should articulate the upper and lower bounds of the duty to care, expand the definition of “risk” to clinicians to encompass psychological well-being and burnout and evaluate how institutions and the public can reasonably provide clinicians with the tools necessary to effectively serve patients.
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Livestream Information

 Zoom
May 24, 2023 (Wednesday) 12:00pm
Meeting ID: 94265362919

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