Virtue Ethics, Moral Authority, and COVID-19

Dr Edmund Pellegrino (1920-2013) talks about personal virtues in shaping ethical behavior and moral authority in promoting the common good.

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Despite anti-intellectualism and medical skepticism, I agree that physicians still need to lead by example and embody virtuous characteristics. It is unproductive to sink to the level of online discourse regarding COVID-19, vaccines, and other so-called medical controversies. I’ve learned from my vaccine elective in medical school to delineate between the vaccine skeptic and the vaccine hesitant, and to above all else, focus on the patient-physician relationship. For the vaccine skeptics, no amount of data or scientific facts tends to shift their opinion one way or the other. One can speculate as to their psychological profile and mentality, but discourse with these individuals can be circular, irrational, and driven by identity. The vaccine hesitant on the other hand tend to have an underlying concern or gap in knowledge about vaccines, and depending on what information they’re given, can lean either way. For example, a lot of mothers can be hesitant about the rigorous vaccine schedule in place for newborns. The amount of injections that newborns and infants have to go through can intimidate some. As the physician, it is imperative to provide information in an impartial and unflappable manner, and delve deeper into what the parent is thinking and act as a partner in the patient-physician relationship. Stern admonishment or protracted lectures are not as effective in swaying patient opinion, and they risk the patient looking elsewhere for vaccine information. I’ve actually used a motivational interviewing format to figure out why one of my relatives was adverse to getting a COVID-19 vaccination. I went into the conversation with an open mind and without the ulterior motive of trying to sway him otherwise. I simply wanted to know what his thought process was, and learn what factors contributed to his medical distrust. He revealed that because of my grandmother’s issue with atrial fibrillation that eventually led to a stroke and her passing, he felt that doctors in the Philippines mismanaged her care. While I knew in the back of my mind that my grandmother had a risk factor such as high cholesterol or an inactive lifestyle that necessitated a quadruple bypass surgery, from which she developed atrial fibrillation, I didn’t try to correct him. I used an exploratory line of questions and tried to empathize with his viewpoint. Whether that affected his perspective remains to be seen, but I prioritized staying in his good graces. On a different note, I’m glad that structural racism is being addressed by medical organizations, and that medical schools are taking steps in the right direction. Some examples of simple solutions include utilizing a variety of skin tones for images of dermatological pathologies, or having standardized patients of different demographic backgrounds. I was astonished to learn that some medical students in this day and age still believed that black people felt pain differently, or that they couldn’t swim. There are more biological similarities between humans than there are differences, despite superficial appearances. And when it comes to stereotypes, most are explained by socioeconomic factors.