Courage and Compassion: Virtues in Caring for So-Called "Difficult" Patients.

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What, if anything, can medical ethics offer to assist in the care of the "difficult" patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the "difficult" patient as an example of a "moral stress test" that especially challenges the physician's character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of "difficult" patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training.






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Hawking, Michael, Farr A Curlin and John D Yoon (2017). Courage and Compassion: Virtues in Caring for So-Called "Difficult" Patients. AMA J Ethics, 19(4). pp. 357–363. 10.1001/journalofethics.2017.19.4.medu2-1704 Retrieved from

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Farr A Curlin

Professor of Medicine

Farr Curlin, MD, is Josiah Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities, & History of Medicine and Co-Director of the Theology, Medicine and Culture Initiative (TMC) at Duke University. Dr. Curlin has worked to bring attention to the intersection of medicine, ethics, and theology. In 2012 he helped to found both the University of Chicago’s Program on Medicine and Religion and the annual Conference on Medicine and Religion. Since 2015, through Duke Divinity School’s TMC Initiative, he and colleagues have brought graduate theological training to those with vocations to health care. Starting in 2023, Dr. Curlin also is working with colleagues across North America to develop the Hippocratic Society, an association of students and practitioners dedicated to fulfilling the profession to heal. He is co-author, with Chris Tollefsen, of The Way of Medicine: Ethics and the Healing Profession (Notre Dame University Press, 2021), as well as more than 150 articles and book chapters addressing the moral and spiritual dimensions of medical practice.

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