Article Gold Open Access 2018

Leadership in palliative medicine: Moral, ethical and educational

BMC Medical Ethics
Journal · Vol. 19 · Issue 1 · Art. 55
Abstract

Background: Making particular use of Shale's analysis, this paper discusses the notion of leadership in the context of palliative medicine. Whilst offering a critical perspective, I build on the philosophy of palliative care offered by Randall and Downie and suggest that the normative structure of this medical speciality has certain distinctive features, particularly when compared to that of medicine more generally. I discuss this in terms of palliative medicine's distinctive morality or ethos, albeit one that should still be seen in terms of medical morality or the ethos of medicine. Main text: I argue that, in the context of multi-disciplinary teamwork, the particular ethos of palliative medicine means that healthcare professionals who work within this speciality are presented with distinct opportunities for leadership and the dissemination of the moral and ethical norms that guide their practice. I expand on the nature of this opportunity by further engaging with Shale's work on leadership in medicine, and by more fully articulating the notion of moral ethos in medicine and its relation to the more formal notion of medical ethics. Finally, and with reference to the idea of medical education as both on going and as an apprenticeship, I suggest that moral and ethical leadership in palliative medicine may have an inherently educational quality and a distinctively pedagogical dimension. Conclusions: The nature of palliative medicine is such that it often involves caring for patients who are still receiving treatment from other specialists. Whilst this can create tension, it also provides an opportunity for palliative care professionals to disseminate the philosophy that underpins their practice, and to offer leadership with regard to the moral and ethical challenges that arise in the context of End of Life Care. © 2018 The Author(s).

Keywords

Author Keywords

Leadership education ethics End of life care morality Curative Palliative Philosophy of medicine Philosophy of palliative care The Asklepian tradition The Hippocratic tradition

Index Keywords

adult human medical education Humans Article ethics education leadership patient care philosophy teamwork specialization patient care team palliative therapy terminal care Palliative Care morality in service training Inservice Training tension medical ethics interdisciplinary communication Ethics, Medical Morals Palliative Medicine Philosophy, Medical
Author Affiliations
Visiting Research Fellow, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom, Endcare Research Fellow, Dublin City University, Dublin, Leinster, Ireland, School of Medicine and Psychology, Canberra, ACT, Australia
Funding & Acknowledgements
Erasmus+
Grant: 2015–1-MT01-KA203–003728
The writing of this paper has been supported by my appointment as Postdoctoral Research Fellow to the ENDCARE project (Harmonisation and Dissemination of Best Practice - Educating and alleviating the concerns of Health Care Professionals on the proper practice of End of Life care) funded by EU ERASMUS+ programme Agreement No. 2015–1-MT01-KA203–003728. The funding body played no role in the conceptualisation or writing of this paper.
Erasmus+
The writing of this paper has been supported by my appointment as Postdoctoral Research Fellow to the ENDCARE project (Harmonisation and Dissemination of Best Practice - Educating and alleviating the concerns of Health Care Professionals on the proper practice of End of Life care) funded by EU ERASMUS+ programme Agreement No. 2015–1-MT01-KA203–003728. The funding body played no role in the conceptualisation or writing of this paper.
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