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The Virtuous Professional and the Marketplace. Chapter in Feiler T, Horden J and Papanikitas A, Marketisation Ethics and Healthcare. Routledge, 2018



What does it mean to be a virtuous professional? This chapter argues that healthcare workers’ communities of practice draw their culture both from moral theory and from the marketplace. The chapter explores how healthcare constructs itself as a professional (as opposed to solely technical or commercial) activity. It explores the role of moral theory (as opposed to instrumental ethical rules) within the practice of medicine. Market forces are most commonly located within a contractarian moral anti-realist framework (although this is not the case for Nozick’s audacious but restricted vision). Whilst deeper moral realist commitments continue to bind much of society together, in the last three decades one particular part of the capitalist narrative, that of market forces, has increasingly dominated western culture. This chapter argues that, whilst classic market theory claims to maximise efficiency of production and distribution of services, it is ill suited to these tasks within a healthcare context. Current trends in healthcare management seek to give precedence to markets, putting stress on the previous adaptive balance between virtue and market forces. This chapter argues that, if healthcare is to pursue the proper goals of medicine, this turn is morally problematic. Notions of human flourishing which give particular priority to the weak and vulnerable are ill adapted to a market narrative that sees no problem in the strong dominating the weak. This chapter examines the moral and professional dilemma caused by this philosophical conflict. It argues that the virtuous practitioner will pursue the telos of medicine rather than market forces. This telos will be motivated by compassion and implemented by wise means, whilst paying attention to the polis or social environment of healthcare, as well as the possible excellences of practitioners.
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