Regarding heroism, I ask you:
Which legally or policy-binding authorities have written criteria that a healthcare professional of interest (fill in the blank: your personal physician, the doctors on your staff, the doctors you are currently training) should use to determine to act heroically?
Yet even though you have no answer for me, you probably expect doctors should act heroically if they find themselves in the position to do so.
If doctors have no written directives to prepare them or require them to choose to act heroically, then where would they turn to discover truth about what the right decision should be in the time of need?
Wouldn’t that be a useful thing for you to know?
Is a police officer who drives to respond to 911 calls a hero simply because of that fact, but not a police officer who works a desk job?
Is an ER physician a hero simply because they deal with emergencies, but not an outpatient family medicine osteopath?
Is a cardiac or transplant surgeon a hero because they deal with vital organs, but not a dermatologic surgeon?
If a surgeon (only) transplants an organ, are they being heroic or are they being professional?
If an osteopath (only) performs a manipulation that takes away all pain, are they being heroic or are they being professional?
How do doctors
become heroes?
Allow me to give you an introductory answer...
HOW DOCTORS CAN THINK HEROICALLY
| Kohlberg stages | pre- conventional | conventional | post- conventional | |||
|---|---|---|---|---|---|---|
| What is the orientation? | heteronomous | intstrumental and relative | interpersonal conformity | social system law & order | social contract | universal ethical principles |
| What takes precedence? | Avoid punishment. | Satisfy my need. | Meet expectations. | Fulfill duties to the highest law. | Live the spirit of the local law if it does not prescribe what to do. | Fulfill duties to universal/global principles (justice, right to life). |
| As a doctor, what should I do? | What will I lose if I help? | What will I gain if I help? | What will people think of me if I help or don't help? | How will I live with myself if I don't help? | What will happen to this person if I do not help? | How would I defend my decision not to help this person before God / for all of history to see? |
| illustration | ||||||
| What do I charge this patient who has no insurance? | I will not upbill in case I get caught and fined. | I will not upbill because I could get a bonus for no errors on my audit. | I will ask for a reduced charge because it would look bad on my group and me to charge full price. | I will ask for a reduced charge on a sliding scale because putting the patient into medical debt is bad for society and my business can afford it. | I will ask for a reduced charge on a sliding scale because I have a moral obligation to provide healthcare services at prices people in my society can afford. | I will advocate that this patient not be charged beyond what he can afford because my moral call is to inch myself and society toward perfection, which means I must uphold justice in this matter. |
Doctors should know:
- what heroism is (what components define it and what those components actually mean).
- why to act heroically, including what ways choosing to do the seemingly hard thing can pay off for their health as well as that of the person they're helping.
- what steps in moral development must occur before heroism can become a regular part of their lives.
- how to recognize the roadblocks to acting heroically and how to effectively maneuver around them.
- strategies for incorporating (cost effective) heroism into the constraints imposed by most medical practices.
- where to go for inspiration to rejuvenate their quest to be the best doctor they can be.
Michael Young's definition of heroism:
situation:
• facing uncertainty in the likelihood of overcoming a challenge
intent:
•to overcome the challenge despite knowing the attempt may mean losing something of great personal value (= courage)
•to act because the effort is morally right
•to benefit someone else, especially someone who can’t fix the problem on their own (= altruism) and not to obtain extrinsic personal rewards like fame/money
behavior/response:
•giving more than customary/ordinary effort
