In this personal reflection, the Author turns the spotlight on virtue ethics as a key pillar of healthcare practice. Relevantly, plenty of insights are offered about basic concepts like fairness, respect, trustworthiness, compassion, courage, caring, integrity, wisdom, among others. 

… ‘in the practice of public health, practitioners are expected to pose these character traits at higher levels than ordinary people because of the vulnerability of the people who seek healthcare services both directly as in the clinical practice and indirectly as in public healthcare’…

By Florence Gune

Human Resources Intern

United Nations Population Fund – UNFPA

New York, USA

Reflection Note

Virtue Ethics in the Healthcare Practice

Teaching duty Vs virtue ethics to make health workers more professional in their practice

Professionals are groups of self-regulating capable of legally prohibiting others from practicing. They must have a group identity, shared education and training, special uncommon knowledge used in services of others, adherence to certain values, penalties for certain performance, and some individual judgment- autonomy in decision making. Professions need a lot of training and intellectual ability to provide services to the community. And this specialized knowledge gives them a monopoly over overuse and teaching allowing them to develop their own code of ethics and regulate them. Ethics for professionals help them to choose what is right when faced with a problem at work that raises moral issues.

What kind of person should I be? Do what is right but not necessarily because they want me to or do what is right because they want me to?

Virtue ethics is considered one of the oldest systems of ethics in the eastern and western cultures and it concentrates on a person’s morals and what kind of person they ought to be. So, it takes human character to be at the center of morality and hence puts less emphasis on the act itself since the moral status of an act depends on the character of the person performing it. That means good people do the right thing automatically to produce good and minimize harm in the world. Virtuous people are very different; they face different basic problems with the same basic needs and have. They will need courage where danger always arises and generosity where others are less well-off and loyalty since they all need friends.

The virtues in the public health practice: a virtuous person is that who bends on doing what is morally acceptable to the majority, so the expectations of the public are very high about healthcare professionals. Therefore, healthcare practitioners are expected to remember these expectations the public has about them for example, to be respected. The character traits of virtue in most societies include but are not limited to being:

Just, by ensuring that fairness is exercised in all matters related to planning and delivering healthcare services to individuals and the community at large. The service provider should be such that every person has the right to respect therefore allowing every person to get what they deserve on weighing all situations surrounding the needs of this person and others. Applying it in the field of public health means that there is fairness in resource distribution to and within the population, otherwise, if one group gets everything and others get nothing conflict may result.
Trustworthy; is by being truthful and worthy of the trust which lies in the heart of the relationship between service providers and the users of the services. This means that the consumers of the health service normally assume that the service providers are committed and competent in performing their jobs and they will not harm them. So, if the service users are to be comfortable, the service providers should conduct themselves in a way that they are worthy of trust and reliability.
Courageous; courage is the ability of an individual not to give up when faced with a challenge. It is necessary for a professional practice that is associated with endurance and the ability to confront fear and act ethically. In the healthcare practice, there is a wide range of fear-inducing situations which can evoke fear of failure, litigation, disapproval, and embarrassment to the clients. Courage is very important in the healthcare practice to respond timely to severely injured persons and outbreaks, for example, to amputate a crashed limb.
Caring; by being concerned and taking necessary steps when faced with a challenge. In the practice of public health, it involves being attentive to the actual or potential needs of the community considering their identified needs and showing appropriate responses in meeting these needs. When a person is caring, it means being responsive to the health needs of the people, so the service provider is expected to show compassion, gentleness, and thoughtfulness when providing the service to the clients.
Respectful; is to have positive consideration of a person or group of persons’ individuality, autonomy, confidentiality, dignity, values, and privacy as complete human beings.
Wise; having wisdom means that a service provider is alert, innovative, and proactive as they carry out their duties in their field of practice. The practitioner should be able to address the concerns of their clients at any time and professionally. This implies that the service provider has the capacity to apply skills and knowledge to suit the situation in which they find themselves. Like in public health practice, wisdom is incorporated in meeting the health needs of the people they serve, for example, making decisions about issues and executing these decisions in an appropriate way. So, wisdom commands people to do the right what they have deliberated and decided to do in a given situation. Therefore, practitioners need to and should be wise in making their decisions and actions.
Integrity: is to be upright even when tempted to do wrong by being sincere, consistent, telling the truth, not abusing one’s position, and keeping a promise. So, a practitioner needs to stick to acceptable principles and values of practice even when confronted with a challenge. Integrity is for example when a health worker refuses to terminate the life of a patient because someone wants them dead.

So, in the practice of public health, practitioners are expected to pose these character traits at higher levels than ordinary people because of the vulnerability of the people who seek healthcare services both directly as in the clinical practice and indirectly as in public healthcare. Hence it is sought and considered essential in promoting the wellbeing of individuals and the population at large. Therefore, this requires that public health practitioners take deliberate actions to ensure that their conduct conforms to desirable character traits by avoiding non virtuous behaviors.

To protect the common good of the person or people, one must consider avoiding all behaviors that are considered vice- the opposite of virtue to safeguard the spirit of communitarianism and solidarity. In view of the African ethical thought, actions are generally considered moral if they reflect positive outcomes for the whole community which is suitable for public health practitioners given its expectations on the providers. Though in today’s real life, many people including health workers hardly want to do anything just for the sake of humanity, with self-aspect becoming the norm.

Duty or Deontology ethics is concerned with what people do and not the consequences of their acts. When considering duty ethics, some acts are considered wrong while others are right, and people have the duty to act accordingly regardless of the good or bad consequences the act may produce. A deontologist considers what action is right and then they proceed no matter what its consequences are. It emphasizes the value of every human being by focusing on giving equal respect to them and forces due regard to be given to the interests of a single person even when those are at odds with the interests of the larger group. It also identifies some acts as always wrong no matter what good they can produce- reflecting the way humans think. It also provides certainty because it is concerned with actions, so if an action is right, then a person should do it and if it is wrong, they shouldn’t do it. It also deals with the intentions and motives of the service provider, for example, if the person didn’t intend to do wrong then the act was an accident. On other hand, duty ethics sets absolute rules and allows for acts that make the earth less a good place because it is not interested in the results it can lead to courses of action that can produce a reduction in the overall happiness of the world. It is also difficult to reconcile conflicting duties with duty ethics because it does not deal with cases where duties are in conflict.