Should Medical Schools Be Schools for Virtue?

In the Republic, Plato recounts the myth of Gyges, who wore a ring that allowed him to become invisible simply by turning the ring around his finger.1 Gyges misused the ring's powers to seduce the wife of the king, kill him, and take over the country. The lesson that Plato drew from this myth was that the person of true virtue is the one who can be trusted to do the right thing, even when no one is looking. In a way, two very different articles in this issue of the Journal of General Internal Medicine can both claim the myth of Gyges as a philosophical ancestor. One is about measuring trust in physicians,2 and the other is about educating medical students to become precisely those sorts of physicians who can be trusted to do the right thing for their patients.3 As Branch writes, “Medicine, after all, is a moral profession.” Yet medicine is increasingly viewed as just another business, and the concept of medicine as a profession, as a “special” endeavor with a different set of moral obligations and expectations,4 has been denounced as elitist, self-serving, and detrimental to the spirit of the competitive marketplace.5–7 Some fear that the recent financial reorganization of health care, premised upon the notion that there is nothing special about medicine, poses a particularly grave threat to the essence of medicine as a profession.8,9 Others argue that the professionalism of medicine can be reconstructed in such a way that it can guard against the financial forces that threaten to undermine its moral potency.10,11