CFS: “Professionalism,” Cambridge Q Healthcare Ethics

The Cambridge Quarterly of Healthcare Ethics (CQ) will initiate a new Department on professionalism in health-related disciplines, and submissions are invited. The goal of the new “Professionalism Department” is to provide a forum for identifying, justifying, and applying standards for determining whether practices, decisions, and actions are professionally required, permitted, or prohibited. Submissions can address professionalism in medicine, nursing, pharmacy, psychology, psychiatry, dentistry, physical therapy or any other health care or allied health discipline. Submissions may take the form of shorter or longer (3000 – 5000 word) articles, case studies, or commentaries.

Conscience-based refusals to provide health related services have occasioned a sizeable literature that explores the requirements of professionalism in a variety of disciplines. However, recent reports of refusals by physicians to provide services to patients for a variety of reasons that are not conscience-based underscore the need for a broader examination of the requirements of professionalism. A Florida urologist reportedly posted a sign on his office door stating: “If you voted for Obama … seek urologic care elsewhere. Changes to your healthcare begin right now, not in four years” (Orlando Sentinel online, April 2, 2010). It has also been reported that more and more physicians are expected to refuse to accept Medicaid or Medicare patients in response to reductions in reimbursement rates. Some pediatricians currently refuse to accept patients if parents will not allow their children to receive MMR (mumps, measles, and rubella) vaccine. Some physicians reportedly have refused to treat patients who engage in “unhealthful behaviors,” such as smoking, failing to control their weight, and abusing alcohol and/or drugs. Submissions might well consider whether any of these actions comprise unprofessional conduct.

Such refusals are only one type of issue that is suitable for the new “Professionalism Department.” Some additional possible topics include: strikes; sex with patients and trainees; gaming the system; prescribing medications for physical and/or cognitive enhancement (e.g., steroids, Adderall, Ritalin, and Provigil); cosmetic surgery; responding to a colleague’s suspected incompetence or impairment due to drugs, alcohol, or illness; obligations toward other members of the profession; professional obligations during pandemics, bioterrorist attacks, and natural disasters; whether professionals have obligations to promote health care access and/or social justice; participation in capital punishment, assisted suicide, euthanasia, enhanced interrogation (torture); collaboration with pharmaceutical or device manufacturers in research or educational activities; standards of care for providers donating services in resource-poor countries; and whether professionals have an obligation to keep their political views to themselves.

These are only a sample of the numerous topics that can be explored in the soon to be launched CQ “Professionalism Department.” Submissions on these or any other topic related to professionalism are welcome. Guidelines for preparing manuscripts are available online at: http://assets.cambridge.org/CQH/CQH_ifc.pdf . All submissions should include an abstract, and should be sent electronically to the Professionalism Department co-editors, Mark Wicclair ( wicclair@pitt.edu ) and David Barnard ( barnard@pitt.edu ).

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