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Physicians as citizens and the indispensability of civic virtues for professional practice
  1. Settimio Monteverde1,2
  1. 1 School of Health Professions, Berne University of Applied Sciences, Bern, Switzerland
  2. 2 Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
  1. Correspondence to Settimio Monteverde, Health Professions, Berne University of Applied Sciences, Bern, Switzerland; settimio.monteverde{at}

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Incivility poses a serious threat to any healthcare system striving for effectiveness without sacrificing the requirements of humanity. Threats to civility within healthcare not only come from individual ‘bad apples’ exhibiting borderline and inacceptable behaviour, as seen in many ‘high-tech, high-risk, high-responsibility’ environments such as operating or emergency rooms.1 They may also be facilitated by ‘bad trees’ or system-immanent, poor healthcare environments.2 This may be the case when healthcare administrations, facing the challenges of political austerity, set budgetary targets that cannot be met without seriously compromising quality of care, patient safety, and the well-being of those professionals working at the ‘sharp end’. Both individual and systemic factors fuel the occurrence of incivility,3 and individuals—rather than institutions—are often held responsible for acts of incivility. Nevertheless, explaining what might trigger incivility can never serve as a justification for it, because ‘in-civility’ —in its literal sense—breaches basic rules of civic cooperation and goodwill, and thus grossly violates the social …

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  • 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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