TY - JOUR T1 - Responsibility as a meta-virtue: truth-telling, deliberation and wisdom in medical professionalism JF - Journal of Medical Ethics JO - J Med Ethics SP - 153 LP - 158 DO - 10.1136/jme.2008.025411 VL - 35 IS - 3 AU - Y M Barilan Y1 - 2009/03/01 UR - http://jme.bmj.com/content/35/3/153.abstract N2 - The article examines the new discourse on medical professionalism and responsibility through the prism of conflicts among moral values, especially with regard to truth-telling.The discussion is anchored in the renaissance of English-language writing on medical ethics in the 18th century, which paralleled the rise of humanitarianism and the advent of the word “responsibility”.Following an analysis of the meanings of the value of responsibility in general and in medical practice in particular, it is argued that, similarly to the Aristotelian notion of equity, responsibility of care is a second-order value, which corrects virtues, laws and norms in exceptional circumstances.Virtues and practices of the second order, such as responsibility and deliberation, bear especially on professional doctoring, which includes a commitment to give priority to the good of the patient over one’s own good.It is argued that, in situations of conflict, and particularly conflicts between personal moral identity and the good of patients, the fundamental professional commitment is to critical and rational deliberation and to the cultivation of psycho-moral flexibility. This leads indirectly to moral growth and strengthening of professional character. ER -