Exploring the premise of lost altruism: content analysis of two codes of ethics

Sep 26, 2017

Authors: Wael Haddara, Lorelei Lingard
 

Journal: Advances in Health Sciences Education

Volume: 22

Issue: 4
 
Publisher: Springer Netherlands
 
Original link:
 

Abstract

As an ideal, altruism has long enjoyed privileged status in medicine and medical education. As a practice, altruism is perceived to be in decline in the current generation. A number of educational efforts are underway to reclaim this “lost value” of medicine. In this paper we explore constructions of altruism over a defined period of time through a content analysis of the Canadian and Australian Medical Associations (CMA and AMA respectively) Codes of Ethics. We analyzed all editions of both Codes (1868–2004), using a content analysis approach, including thematic analysis. We coded as altruistic or non-altruistic, respectively, statements in which the interest of the patient is placed ahead of the physician’s and statements in which the interest of the physician is given primacy. We examined the pattern of appearance and disappearance of these statements over time. We identified 13 altruistic and 2 non-altruistic statements across all editions. There is a gradual and uneven loss of altruistic content over time. The CMA Codes of 1938, 1970 and 2004 and the AMA code of 1992 represent significant change points. The most recent versions of both Codes contain only 1 altruistic statement and both non-altruistic statements. We conclude that altruism appears to be a fluid and changing concept over time. Loss of altruism is not merely a current generational issue but extends through the past century and is likely due to political and social forces. These results call into question current educational attempts to reclaim altruism, and point to the social evolution of the ideal.

 
 
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Acknowledgments

Lorelei Lingard is supported as a scientist in the Program of Experimental Medicine in the Department of Medicine at the Schulich School of Medicine and Dentistry, Western University.

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Affiliations

  1. Divisions of Critical Care Medicine and Endocrinology and Metabolism, Department of Medicine, Schulich School of Medicine, Western University, 339 Windermere Road, Office B2-194, London, ON, N6G 2K1, Canada

    Wael Haddara

  2. Department of Medicine, The Faculty of Education, The Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Lorelei Lingard

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  1. Wael Haddara
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Correspondence to Wael Haddara.

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Cite this article

Haddara, W., Lingard, L. Exploring the premise of lost altruism: content analysis of two codes of ethics. Adv in Health Sci Educ 22, 839–852 (2017). https://doi.org/10.1007/s10459-016-9713-6

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Keywords

  • Altruism
  • Medical education
  • Codes of ethics