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The practice of medicine is full of ethical challenges. Although ethical principles and organizational formats can help clinicians manage these challenges, they do not necessarily help them develop the routine habit of bringing a focused ethical attentiveness to every patient encounter. In this article, the author—a seasoned generalist practitioner—describes how he has personally worked to cultivate this habit by holding in mind four introspective intentions. These intentions are aimed at alleviating suffering, promoting dignity, recognizing interdependency, and advancing wisdom, respectively. The author presents these intentions, reviews some benefits by which they enhance his work, and discusses some concerns they pose. He concludes by inviting other health care professionals and bioethical specialists to consider integrating intentions into their own clinical and consultative practices.
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Ventres WB. The joy of family practice. Ann Fam Med 2012;10(3):264-8. doi: 10.1370/afm.1372
Ventres WB. How I think: perspectives on process, people, politics, and presence. J Am Board Fam Med 2012;25(6):930-6. doi: 10.3122/jabfm.2012.06.120093
Beauchamp TL, Childress JF. Principles of Biomedical Ethics, 7th ed. New York, NY: Oxford University Press 2013.
Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, 7th ed. New York, NY: McGraw Hill 2010.
Tong R. The ethics of care: a feminist virtue ethics of care for healthcare practitioners. J Med Philos 1998;23(2)131-52.
Rivas-Muñoz R, Garrafa V, Feitosa SF, Flor de Nascimento W. “Bioética de intervención, interculturalidad y no-colonialidad” [“Bioethics of intervention, inter-culturality and non-coloniality”], Saúde Soc (São Paulo) 2015;24(suppl 1):141-51. doi: 10.1590/S0104-12902015S01012
Charon R, Brody H, Clark MW, et al. Literature and ethical medicine: five cases from common practice. J Med Philos 1996;21(3);243-65.
Ventres WB. Looking within: intentions of practice for person-centered care. Ann Fam Med 2017;15(2):171-4. doi: 10.1370/afm.2037
Hastings Center. The goals of medicine. Setting new priorities. Hastings Center Rep. 1996;26(6)(suppl.):S1-27.
Cassell E. The nature of suffering and the goals of medicine. New Engl J Med 1982;306:639-45.
Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry 1980;137(5):535-44.
Carmichael LP, Carmichael JS. The relational model in family practice. Marriage Fam Rev 1982;(4):123-33.
Egnew TR. The meaning of healing: transcending suffering. Ann Fam Med 2005;3(3):255-62.
Ventres WB. The Q-list manifesto: how to get things right in generalist medical practice. Fam Syst Health 2015;33(1):5–13. doi: 10.1037/fsh0000100
Ventres W. Cultural encounters and family medicine: six lessons from South America. J Am Board Fam Pract 1997;10(3):232-6.
Ventres WB. Where I practice: on the spaces of family medicine. J Am Board Fam Med 2015;28(6):841-4. doi: 10.3122/jabfm.2015.06.150021
Chochinov HM. Dignity and the essence of medicine: the A, B, C and D of dignity conserving care. BMJ 2007;335(7612):184-7.
Macklin R. Dignity is a useless concept. BMJ 2003;327(7429):1419-20.
Ventres WB, Frankel RM. Shared presence in physician-patient communication: a graphic representation. Fam Syst Health 2015;33(3):270-9. doi: 10.1037/fsh0000123
Ventres W, Dharamsi S, Ferrer R. From social determinants to social interdependency: theory, reflection, and engagement. Soc Med 2017;11(2):84-9.
Edmondson R, Pearce, J. The practice of health care: wisdom as a model. Med Health Care Philos 2007;10(3):233-44.
Frank AW. Ethics as process and practice. Intern Med J 2004;34(6):355-7.
Mechanic D. Physician discontent: challenges and opportunities. JAMA 2003;290(7):941-6.
Epstein RM, Krasner MS. Physician resilience: what it means, why it matters, and how to promote it. Acad Med 2013; 88(3):301-3. doi: 10.1097/ACM.0b013e318280cff0
Beach MC, Roter D, Korthuis PT, et al. A multicenter study of physician mindfulness and health care quality. Ann Fam Med 2013:11(5):421-8. doi: 10.1370/afm.1507