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Abstract
The medical profession contains five “spheres of morality”: clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients’ well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts.
Notes
1 We are grateful to an anonymous reviewer for this point
2 Physicians may contribute to society in other ways that we do not discuss here, for instance by holding public office, but we limit ourselves here to the most common spheres, requiring medical knowledge or clinical skills, that are related or adjacent to the pursuit of health. These common spheres will be familiar to most, if not all, physicians.
3 We are grateful to an anonymous reviewer for this point.