Severe acute respiratory syndrome and its impact on professionalism: qualitative study of physicians' behaviour during an emerging healthcare crisis
Sharon E Straus, Kumanan Wilson, Gloria Rambaldini, Darlyne Rath, Yulia Lin, Wayne L Gold and Moira K Kapral BMJ 2004;329;83; originally published online 2 Jun 2004; doi:10.1136/bmj.38127.444838.63Updated information and services can be found at: http://bmj.com/cgi/content/full/329/7457/83
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Severe acute respiratory syndrome and its impact on professionalism: qualitative study of physicians’ behaviour during an emerging healthcare crisisSharon E Straus, Kumanan Wilson, Gloria Rambaldini, Darlyne Rath, Yulia Lin, Wayne L Gold, Moira K Kapral
Objective To explore issues of medical professionalism in the context of severe acute respiratory syndrome (SARS), a new emerging health threat. Design Qualitative interviews analysed with grounded theory methodology. Setting University hospitals in Toronto, Canada, during theSARS outbreak in 2003. Participants 14 staff physicians from divisions of infectious diseases, general internal medicine, and critical care medicine. Results Of 14 attending physicians, four became ill during the outbreak. Participants described their experiences during the outbreak and highlighted several themes about values inherent to medical professionalism that arose during this crisisincluding the balance between care of patients and accepted personal risk, confidentiality, appropriate interactions between physicians and patients, ethical research conduct, and role modelling of professionalism for junior doctors. Conclusion Despite concerns raised by professional societies about the erosion of professionalism, participants in this study amply demonstrated the necessary qualitiesduring the recent healthcare crisis. However, there were several examples of strained professional behaviour witnessed by the participants and these examples highlight aspects of medical professionalism that medical educators and professional organisations should address in the future, including the balance between personal safety and duty of care.
The recent outbreak of severe acute respiratorydistress syndrome (SARS) allows an opportunity to explore medical professionalism in the context of a new emerging health threat. Stories of personal heroics of physicians who knowingly exposed themselves to contagious and often fatal illnesses with little understanding of the disease abound in history. Similarly history provides stories of physicians who avoided responsibility for treating such...