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Incentivising civility in clinical environments
  1. Tamara Kayali Browne1,2,
  2. Zohar Lederman3
  1. 1 School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
  2. 2 Practical and Public Ethics Research Group, Faculty of Arts, Charles Sturt University, Wagga Wagga, New South Wales, Australia
  3. 3 Medical Ethics and Humanities Unit, Hong Kong University, Hong Kong, Hong Kong
  1. Correspondence to Dr Tamara Kayali Browne, Deakin University School of Medicine, Geelong, VIC 3220, Australia; tamara.browne{at}

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Agent-based or system-based interventions?

Several months ago, an Israeli resident in emergency medicine engaged in a hunger strike to protest 26-hour shifts. His protest was part of a country-wide struggle of medical residents from all disciplines against such long shifts, arguing that they are a thing of the past, and that they harm patient care. While there is actually no evidence that long shifts harm patient outcomes, they very likely reduce civility among staff members and towards patients.1 Two kinds of strategies are possible to address this likely source of incivility: expect and train residents to be kinder and more patient towards their peers and patients, or do away with long shifts. Therein lies the tension in implementing the case for civility made by McCollough et al 2 should we invest in agent-based or system-based interventions?

Virtue ethics is prominent in discussions of the professional duties of healthcare providers (HCPs). A common theme that threads throughout these discussions is that HCPs ought to, or are expected to behave in a kind, patient and sensitive manner towards their peers and patients, …

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  • Twitter @BrowneKayali

  • Contributors TKB initiated this commentary proposal but both authors have both contributed ideas and written this proposal together.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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