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Phronesis and the Medical Community

Dr Mervyn Conroy discusses the Phronesis and the Medical Community project which will explore the ethical dimension of good decision making in the context of medical leadership in order to improve patient care and experience.

University of Birmingham Aston Webb building

But how does the medical profession, as well as the health service more broadly regulate the good conduct of doctors? One answer surely lies with a strong regulatory regime. While few can doubt the sound intentions that underpin efforts to make clearer rules for how doctors should conduct themselves – and for enforcing these rigorously – practitioners also speak of unintended consequences. Rules for professional conduct often do not capture all cases, they sometimes conflict with one another and efforts to demonstrate compliance with rules and regulations are time consuming. Last but not least, fears of legal action sometimes lead to defensive practice.

Many doctors call for the protection of the doctor’s freedom to make professional judgements within a system of regulating professional behaviour. But how should we think about and study what professional and ethical judgment amounts to? Moreover, how do doctors develop this form of professional judgement and can it be taught.

The Phronesis and the Medical Community project recently launched at HSMC attempts to answer some of these questions. The project takes its inspiration from Aristotle’s conception of ethics (revived in recent years by figures like MacIntyre). For Aristotle, phronesis, or practical wisdom, is the virtue of a person who can choose wisely between different moral aims and knows how to achieve the best aim through practical action. This kind of practical wisdom – to be able to judge what outcome to achieve and the wisdom to know how to achieve this, practically speaking is  exactly the kind of judgement that one hopes doctors can make. In their book The Virtues in Medical Practice, Pellegrino and Thomasma, for instance, hold that many of a doctor’s day-to-day decisions require the careful weighing up of all the different priorities for their patients – and deciding which is the most important one and how to promote it.

While this has clearly been recognised in the theory of medical practice, no empirical studies exist on what doctors think phronesis is, how it is cultivated or how it can be promoted. A three study led by Dr Mervyn Conroy, Senior Fellow at HSMC, and funded by the Arts and Humanities Research Council will seek to answer these questions and animate the findings in a video series linked to an existing virtual community. More details of the research are provided through the link below.

For further information please contact the Principal Investigator: 

Dr Mervyn Conroy
Senior Fellow
Health Services Management Centre
University of Birmingham
Park House, 40 Edgbaston Park Rd
Birmingham, B15 2RT