Abstracts
Abstract
Polarization and incivility are on the rise, negatively affecting collegiality, workplace relationships, morale, and performance at work. The authors argue for the need for civil discourse in medicine and for embracing complexity as an essential component of that civil discourse, facilitating nuanced thinking, respectful dialogue, and greater understanding of other perspectives. This principle of embracing complexity is congruent with the attitude of physicians, who are trained to tolerate uncertainty and to hold and appreciate multiple perspectives in making diagnoses and choosing and proposing treatment plans. This understanding of civil discourse does not amount to moral relativism, whataboutism, or an embracing of both sides of an argument universally, nor does it serve as a cudgel to silence or to perpetuate hegemonic power. Instead, the principles of civil discourse clarify multiple aspects of the boundaries of professional conduct, outlining how physicians can engage in advocacy for patients and communities while maintaining collegial relationships and the perception that they will be safe providers for all patients. The rights of citizens in democracies, including to engage in peaceful protest and to say anything within the bounds of their country’s laws governing free speech, do not extend unabbreviated into the lives of professionals, who are limited by the privileges afforded to them and by the responsibilities they have to their patients and colleagues. By embracing complexity and nuance over simplism and slogans, physician colleagues who disagree with one another can communicate respectfully, advocate professionally, and be safe and effective care providers to all patients.
Résumé
La polarisation et l'incivilité sont en hausse, ce qui a un impact négatif sur la collégialité, les relations de travail, le moral et les performances professionnelles. Les auteurs plaident en faveur de la nécessité d'un discours civilisé en médecine et de l'acceptation de la complexité comme élément essentiel de ce discours civilisé, facilitant une réflexion nuancée, un dialogue respectueux et une meilleure compréhension des autres points de vue. Ce principe d'acceptation de la complexité est conforme à l'attitude des médecins, qui sont formés à tolérer l'incertitude et à considérer et apprécier de multiples points de vue lorsqu'ils établissent des diagnostics et choisissent et proposent des plans de traitement. Cette conception du discours civil n'équivaut pas à un relativisme moral, à une contre-attaque (« whataboutism ») ou à une acceptation universelle des deux côtés d'un argument, ni ne sert de bâton pour faire taire ou perpétuer un pouvoir hégémonique. Au contraire, les principes du discours civil clarifient de multiples aspects des limites de la conduite professionnelle, en décrivant comment les médecins peuvent s'engager dans la défense des patients et des communautés tout en maintenant des relations collégiales et l'image de prestataires de soins sécuritaires pour tous les patients. Les droits des citoyens dans les démocraties, notamment celui de participer à des manifestations pacifiques et de s'exprimer librement dans les limites des lois de leur pays régissant la liberté d'expression, ne s'étendent pas sans restriction à la vie des professionnels, qui sont limités par les privilèges qui leur sont accordés et par les responsabilités qu'ils ont envers leurs patients et leurs collègues. En privilégiant la complexité et la nuance plutôt que le simplisme et les slogans, les collègues médecins qui ne sont pas d'accord entre eux peuvent communiquer de manière respectueuse, défendre leurs intérêts de manière professionnelle et être des prestataires de soins sécuritaires et efficaces pour tous les patients.
Appendices
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