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This chapter questions the role of virtues in health professional medical ethics. It distinguishes between the ethics of conduct – usually expressed as moral principles – and the ethics of the character – expressed as virtues. It questions whether virtues are intrinsically valued or valued instrumentally as the means to right conduct. It poses two problems for virtue theory: (1) The “naked virtue” problem – whether instilling virtues increases the probability of correlative morally right conduct, and (2) the “wrong virtue” problem–which of many sometimes controversial virtues should be promoted. The chapter ends by arguing that these are less serious problems for the morality of conduct.

Recent accreditation standards have changed for all US and Canadian medical schools and residency programs. Newly mandated knowledge, skills, behavior, and attitudes required of the learner to become a medical professional are permeated with professionalism and associated curricular themes. The art of medicine now emphasizes humanistic skills, ethical precepts, and principle-based values. To this end, this chapter calls for enhanced learner collaboration with educators, as well as a required longitudinal ethics curriculum and medical apprenticeship for all phases of medical education. These efforts can thereby result in greater moral reflection on professionalism and its successful assimilation into clinical practice.

This chapter reviews the evidence of the development of ethical decision-making competencies of medical professionals. Selected studies are reviewed that use a theoretical framework that has shown the most promise for providing evidence of character formation. The evidence suggests that entering professionals lack full capacity for functional processes that give rise to morality (sensitivity, reasoning, motivation and commitment, character and competence). Further, following professional education, considerable variations in these abilities persist. Whereas many perceive that role modeling is the most effective way to teach professionalism, there is no empirical evidence to support the role of modeling in professional development. The chapter concludes with suggestions for facilitating character development resistant to influence by negative role models or adverse moral milieu.

The purpose of this paper is to draw on previous work in multiple disciplines to establish a theoretical framework for clinical decision-making that incorporates non-medical factors, such as race/ethnicity, into the way physicians make decisions in the practice of medicine. The proposed Rapid Clinical Decision in Context (RCDC) model attempts to understand the influence of various contextual elements on physicians’ decision-making process. The RCDC model provides a basis for future studies to move beyond documentation of areas where disparities exist to understand the causes of the disparities and designing interventions to address those causes. The paper concludes with a discussion on possible studies to test the proposed model.