Should include respect

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6969.1658b (Published 17 December 1994) Cite this as: BMJ 1994;309:1658
  1. Valerie Iles
  1. Director, Health Management Group, City University, London EC1V 0HB

    EDITOR,—Richard Smith's editorial on the summit meeting on medicine's core values indicates a misunderstanding within the profession of the concept of respect.1 The answer to the question “How … could doctors balance respecting each other with having to act to stop a colleague who might be harming patients?” is that no balancing is required. Genuine respect for a person (which must be earned rather than demanded) includes a respect for his or her integrity, desire to contribute, and ability to receive bad news and use it constructively. Thus respect for a colleague who may be harming patients requires not hiding the truth and devising complicated ways of working around it but gently but firmly breaking it. Indeed, withholding the truth in this situation would be an act of patronising cowardice, whereas genuine respect requires courage and humility. Perhaps it was this diminished perception of respect that led to its exclusion, and the exclusion of anything resembling it, from the final list of core values. This seems a pity because without it the list seems not to encompass some of the important points raised during the meeting.

    It would be interesting to know what hard evidence there is to support the assertion that doctors and managers have value systems that are in fundamental conflict. As someone who is neither but who educates both, I find their values to be similar. They sometimes surprise each other, however, by discovering that members of neither group have two horns and a tail.


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