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Ethics and Teaching Mindfulness to Physicians and Health Care Professionals

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Practitioner's Guide to Ethics and Mindfulness-Based Interventions

Part of the book series: Mindfulness in Behavioral Health ((MIBH))

Abstract

This chapter, Ethics and Teaching Mindfulness to Physicians and Health care Professionals, explores the healing potential of the medical professional–patient relationship that can be realized when approaching the suffering dimension in health care with mindful attention and awareness. We will examine, through the lens of personal narratives and professional reflections, the need for a greater sense of belonging and mentorship among health professionals within the dynamic of a changing and challenging health care system, where more than 50% of health care professionals experience varying degrees of burnout, a problem that has been demonstrated to contribute to poorer quality of care and caring. The ethical imperative to address burnout and build resilience among medical professionals includes intimately examining the intrapersonal, interpersonal, and systemic challenges within the clinical dynamic. This chapter will also explore the ethical challenges for students and medical professionals in undergraduate, graduate, and continuing medical education, including the deleterious effects of the hidden curriculum and the salutary effects of mindfulness-based approaches. Drs. Michael Krasner and Patricia Lück offer their personal perspectives including their own individual stories of coming to teaching mindfulness approaches in medical education, their roles in the development of a novel mindfulness-based intervention called Mindful Practice, and how Mindful Practice is finding its way into medical professional education, supporting the growth of a healthier medical community, mentorship, resilience, and compassionate action through the use of mindfulness, narrative medicine, and appreciative inquiry.

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References

  • Allen, W. (1979, August 10). My speech to the graduates. New York Times, 25.

    Google Scholar 

  • AMA Code of Medical Ethics. (2001). Retrieved March 26, 2017, from https://www.ama-assn.org/sites/default/files/media-browser/principles-of-medical-ethics.pdf

  • Antonovsky, A. (1979). Health, stress and coping. San Francisco, CA: Jossey-Bass Publishers.

    Google Scholar 

  • Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making-the pinnacle of patient care. The New England Journal of Medicine, 366, 780–781.

    Article  PubMed  Google Scholar 

  • Batchelor, S. (n.d.). A Buddhist Brexit: A secular reimagining of the dharma may help us face political calamity. Tricycle Magazine, 26(Spring).

    Google Scholar 

  • Beach, M. C., & Inui, T. (2006). Relationship-centered care: A constructive reframing. Journal of General Internal Medicine, 21(Suppl 1), S3–S8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Beauchamp, T., & Childress, J. (2012). Principles of biomedical ethics (7th ed.). Oxford: Oxford University Press.

    Google Scholar 

  • Beckman, H. B., Markakis, K. M., Suchman, A. L., & Frankel, R. M. (1994). The doctor-patient relationship and malpractice: Lessons from plaintiff depositions. Archives of Internal Medicine, 154(12), 1365–1370.

    Article  PubMed  Google Scholar 

  • Beckman, H., Wendland, M., Mooney, C., Krasner, M. S., Quill, T. E., Suchman, A. L., & Epstein, R. M. (2012). The impact of a program in mindful communication on primary care physicians. Academic Medicine, 87(6), 1–5.

    Article  Google Scholar 

  • Bodhi, B. (2005). In the Buddha’s words: An anthology of discourses from the Pali canon. Boston, MA: Wisdom Publishers.

    Google Scholar 

  • Budd, S., & Sharma, U. (1994). The Healing bond: The patient-practitioner relationship and therapeutic responsibility. London: Routledge.

    Book  Google Scholar 

  • Cassell, E. (1982). The nature of suffering and the goals of medicine. New England Journal of Medicine, 306(11), 639–645.

    Article  Google Scholar 

  • Charon, R. (2001a). Narrative medicine: Form, function and ethics. Annals of Internal Medicine, 134, 83–87.

    Article  PubMed  Google Scholar 

  • Charon, R. (2001b). The patient-physician relationship. Narrative medicine: A model for empathy. Journal of the American Medical Association, 286, 1897–1902.

    Article  PubMed  Google Scholar 

  • Charon, R. (2006). Narrative medicine: Honoring the stories of illness. Oxford: Oxford University Press.

    Google Scholar 

  • Cooperider, D. L., & Whitney, D. (2005). Appreciative inquiry: A positive revolution in change. San Francisco, CA: Berrett-Koehler.

    Google Scholar 

  • Crane, M. (1998). Why burned-out doctors get sued more often. Medical Economics, 75(10), 210–212., 215–218.

    PubMed  Google Scholar 

  • Crane, R. S., Brewer, J. A., Feldman, C., Kabat-Zinn, J., Santorelli, S. F., Williams, J. M. G., & Kuyken, W. (2016, December 29). What defines mindfulness-based programs? The warp and the weft. Psychological Medicine, 1–10.

    Google Scholar 

  • Doyle, D. (2005). Dr. Doyle receives Lifetime Achievement Award from American Academy of Hospice and Palliative Medicine. International Association for Hospice and Palliative Care Newsletter, 6(2).

    Google Scholar 

  • Dyrbye, L. N., Thomas, M. R., Huschka, M. M., Lawson, K. L., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D. (2006). A multicenter study of burnout, depression, and quality of life in minority and nonminority US medical students. Mayo Clinic Proceedings, 81(11), 1435–1442.

    Article  PubMed  Google Scholar 

  • Eisenberg, J. (1979). Sociologic influences on decision-making by clinicians. Annals of Internal Medicine, 90(6), 957–964.

    Article  PubMed  Google Scholar 

  • Ekman, E., & Krasner, M. (2017). Empathy in medicine: Neuroscience, education and challenges. Medical Teacher, 39(2), 164–173.

    Article  PubMed  Google Scholar 

  • Epstein, R. (1999). Mindful practice. Journal of the American Medical Association, 282(9), 833–839.

    Article  PubMed  Google Scholar 

  • Epstein, R. (2003). Mindful practice in action (II): Cultivating habits of mind. Families, Systems & Health, 21, 11–17.

    Article  Google Scholar 

  • Fitzgerald, F. (1999). Curiosity. Annals of Internal Medicine, 130(1), 70–72.

    Article  PubMed  Google Scholar 

  • Flexner, A. (1910). Medical education in the United States and Canada: A report to the Carnegie Foundation for the Advancement of Teaching. Boston: Updyke.

    Google Scholar 

  • Gerrity, M. S., Earp, J. A. L., DeVellis, R., & Light, D. (1992). Uncertainty and professional work: Perceptions of physicians in clinical pratice. American Journal of Sociology, 97(4), 1022–1051.

    Article  Google Scholar 

  • Good, B. (1994). Medicine, rationality, and experience: An antropological perspective. Lewis Henry Morgan Lectures. Cambridge: Cambridge University Press.

    Google Scholar 

  • Greenhut, J. (1995). Living without hope. Second Opinion, 21(1), 27.

    Google Scholar 

  • Groopman, J. (2007). How doctors think. Boston, MA: Houghton Mifflin Harcourt.

    Google Scholar 

  • Haas, J. S., Cleary, P. D., Puopolo, A. L., Burstin, H. R., Cook, E. F., & Brennan, T. A. (2000). Is the porfessional satisfaction of general internists associated with patient satisfaction? Journal of General Internal Medicine, 15(2), 122–128.

    Article  PubMed  PubMed Central  Google Scholar 

  • Halpern, J. (2011). From detached concern to empathy: Humanizing medical practice. Oxford: Oxford University Press.

    Google Scholar 

  • Horowitz, C. R., Suchman, A., Branch, W. T., & Frankel, R. M. (2003). What do doctors find meaningful about their work? Annals of Internal Medicine, 138(9), 772–776.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York, NY: Bantam Dell.

    Google Scholar 

  • Kabat-Zinn, J. (2014). Mindfulness and learning: An interdisciplinary symposium. Baltimore: Johns Hopkins University.

    Google Scholar 

  • Kearney, M. K., Weininger, R. B., Vachon, M. L., Harrison, R. L., & Mount, B. M. (2009). Self-care of physicians caring for patients at the end of life “Being connected … a key to my survival”. Journal of the American Medicial Association, 301(11), 1155–1164.

    Article  Google Scholar 

  • Krasner, M. S., Epstein, R. M., Beckman, H., Suchman, A. L., Chapman, B., Mooney, C. J., & Quill, T. E. (2009). Association of an educational program in mindful communication with burnout, empathy and attitudes among primary care physicians. Journal of the American Medical Association, 302(12), 1284–1293.

    Article  PubMed  Google Scholar 

  • Lempp, H., & Seale, C. (2004). The hidden curriculum in undergraduate medical education: Qualitative study of medical students’ perceptions of teaching. British Medical Journal, 329(7469), 770–773.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lück, M. (2015, September). Intimacy in the clinical encounter: It’s not what you think. MSc Medical Humanities Dissertation, Kings College, London.

    Google Scholar 

  • Ludwig, D., & Kabat-Zinn, J. (2008). Mindfulness in medicine. Journal of the American Medical Association, 300, 1350–1352.

    Article  PubMed  Google Scholar 

  • Marsh, H. (2014). Do no harm: Stories of life, death and brain surgery. London: Weidenfeld and Nicholson.

    Google Scholar 

  • Miller, W. L., Crabtree, B. F., Nutting, P. A., Stange, K. C., & Jaén, C. R. (2010). Primary care practice development: A relationship-centered approach. Annals of Family Medicine, 8(Supplement 1), S68–S79.

    Article  PubMed  PubMed Central  Google Scholar 

  • National Library of Medicine. (n.d.). Retrieved February 12, 2017, from National Library of Medicine Website: https://www.nlm.nih.gov/hmd/greek/greek_oath.html

  • OCR GCSE SHP Student Book chapter. (n.d.). Retrieved February 12, 2017, from OCR GCSE History A: Medicine through time: https://www.pearsonschoolsandfecolleges.co.uk/AssetsLibrary/SECTORS/Secondary/SUBJECT/HistoryandSocialScience/HistoryChapters/OCRGCSESHPStudentBookchapter.pdf

  • Ofri, D. (2013). What doctors feel: How emotions affect the practice of medicine. Boston, MA: Beacon Press.

    Google Scholar 

  • Oliver, M. (1992). Newand selected poems. Boston, MA: Beacon Press.

    Google Scholar 

  • Page, K. (2012). The four principles: Can they be measured and do they predict ethical decision making? BioMed Central Medical Ethics, 13(10), 1–8.

    Google Scholar 

  • Peabody, F. (1927). The care of the patient. Journal of the American Medical Association, 88, 877–882.

    Article  Google Scholar 

  • Rabow, M., Remen, R., Parmelee, D. X., & Inui, T. S. (2010). Professional formation: Extending medicine’s lineage of service into the next century. Academic Medicine, 85, 310–317.

    Article  PubMed  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2002). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68–78.

    Article  Google Scholar 

  • Santorelli, S. (1998). Heal thyself: Lessons on mindfulness in medicine. New York, NY: Bell Town.

    Google Scholar 

  • Shanafelt, T. D., Sloan, J., & Habermann, T. M. (2003). The well-being of physicians. American Journal of Medicine, 114(6), 513–519.

    Article  PubMed  Google Scholar 

  • Sibinga, E. M. S., & Wu, A. W. (2010). Clinician mindfulness and patient safety. Journal of the American Medical Association, 304(22), 2532–2533.

    Article  PubMed  Google Scholar 

  • Soltes, E. (2017, January 11). Why it’s so hard to train someone to make an ethical decision. Harvard Business Review.

    Google Scholar 

  • Stange, K.C., Peigorsh, K.M., Miller, W.L. (2003) Families, Systems and Health, 21, 24–27.

    Google Scholar 

  • West, C. P., Huschka, M. M., Novotny, P. J., Sloan, J. A., Kolars, J. C., Habermann, T. M., & Shanafelt, T. D. (2006). Association of perceived medical errors with resident distress and empathy: A prospective longitutdinal study. Journal of the American Medical Association, 296(9), 1071–1078.

    Article  PubMed  Google Scholar 

  • Yavari, N. (2016). Does medical education erode medical trainees’ ethical attitude and behavior? Journal of Medical Ethics and History of Medicine, 9, 16.

    PubMed  PubMed Central  Google Scholar 

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Correspondence to Michael Krasner MD .

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Krasner, M., Lück, P. (2017). Ethics and Teaching Mindfulness to Physicians and Health Care Professionals. In: Monteiro, L., Compson, J., Musten, F. (eds) Practitioner's Guide to Ethics and Mindfulness-Based Interventions . Mindfulness in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-319-64924-5_5

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