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Declining altruism in medicine

BMJ 2002; 324 doi: (Published 16 March 2002) Cite this as: BMJ 2002;324:624

Understanding medical altruism is important in workforce planning

  1. Roger Jones (, Wolfson professor of general practice
  1. Department of General Practice and Primary Care, Guy's, King's College and St Thomas's Hospitals Schools of Medicine and Dentistry, London SE11 6SP

    Altruism, the performance of cooperative unselfish acts beneficial to others, has been studied in several medical contexts, including the donation of organs and genetic material and patients' participation in potentially hazardous experiments and trials.1 Physicians' altruism towards their patients and others has been less well studied and is implicit, rather than explicit, in statements about medical professional values and attitudes. Altruism is, however, embodied in many cultural stereotypes of the “good doctor,” such as John Berger's country practitioner in A Fortunate Man.2

    Altruistic behaviour by physicians might include, for example, continuing to work or providing informal medical advice outside contracted hours, giving free treatment to poor patients in fee for service healthcare systems, and a general willingness to go the extra mile in professional activities. There is much evidence that many doctors work beyond their contracted hours, but there is also a growing feeling that altruism in medicine, if not dying, is at least declining.

    This might be expressed, for example, in the anaesthetist's …

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