Understanding the ethical implications of the rituals of medicine

Abstract

Rituals may be understood broadly as stereotyped behaviours carrying symbolic meanings, which play a crucial role in defining relationships, legitimating authority, giving meaning to certain life events and stabilising social structures. Despite intense interest in the subject, and an extensive literature, relatively little attention has been given to the nature, role and function of ritual in contemporary medicine. Medicine is replete with ritualistic behaviours and imperatives, which play a crucial role in all aspects of clinical practice. Rituals play multiple, complex functions in clinical interactions and have an important role in shaping interactions, experiences and outcomes. Longstanding medical rituals have been disrupted in the wake of coronavirus disease 2019 (COVID‐19). Medical rituals may be evident or invisible, often overlap with or operate alongside instrumentalised practices, and play crucial roles in establishing, maintaining and guaranteeing the efficacy of clinical practices. Rituals can also inhibit progress and change, by enforcing arbitrary authority. Physicians should consider when they are undertaking a ritual practice and recognise when the exigencies of contemporary practice are affecting that ritual with or without meaning or intention. Physicians should reflect on whether aspects of their ritual interactions are undertaken on the basis of sentiment, custom or evidence‐based outcomes, and whether rituals should be defended, continued in a modified fashion or even abandoned in favour of new behaviours suitable for and salient with contemporary practice in the interests of patient care.

Infection Rate Comparison during Transition from Hospital to Office WALANT Enabled by Virtual Reality

“…The practice of medicine is replete with ritualistic behaviors, which serve other motives in addition to any practical effects. 28 Indeed cleansing rituals have been depicted as an example of a “Macbeth effect,” serving both moral and practical purposes. 29 As physicians we need to be cognizant of the possibility that behind our behaviors may lie the bones of a more ancient cultural meme that serves to drive these behaviors beyond their practical application.…”

Biographical Renewal and its Facilitators in Cancer Survivorship: A Conceptual Paper

“…Social rituals are integral to human life in various ways, such as in substantiating social structures, defining relationships, authorising professional milestones, and sometimes finding meaning in particular life events. [ 33 ] Broadly speaking, ritualistic behaviors are symbolic, help represent difficult times in oversimplified images, and empower a person. In the modern period, rituals relate to celebrating milestones in personal and professional life, such as birthdays, marriage, graduation, and promotions.…”

Rituale: Kultur und Psychologie, Pro und Kontra

“…So erklärt sich beispielsweise, warum ein Waschzwang so weit gehen kann, dass die Haut von Händen und Unterarmen dermatologisch versorgt werden muss. Umgekehrt ist die Medizin voller Rituale 1 : Die körperliche Untersuchung erfolgt nach einem bestimmten Ritual. Und viele Therapien werden nach ganz bestimmten Ritualen durchgeführt – von der Chirurgie bis zur Psychotherapie.…”

“…", kann man in der Concise Routledge Encyclopedia of Philosophy (S. 774) dazu nachlesen. 1 Und weiter heißt es dort: "Aus philosophischer Sicht werfen Rituale Fragen auf, denn aus keinem der gängigen Ansätze in der Ethik lassen sich der moralische Wert von Ritualen zwanglos ableiten oder gar deren wesentliche Bedeutung für moralisches Handeln einsichtig machen. Aber in genau diesen Zusammenhängen werden Rituale in Gemeinschaften und von Praktikern gesehen."…”