First, Do No Harm - To Our Own: Addressing Physician Burnout Through the Ethics of Care

open_access
Open Access
Author:
Lochan, Dev
Area of Honors:
Premedicine
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
Hobart H Cleveland, III, Thesis Supervisor
Melissa Krajcovic, Thesis Honors Advisor
Margaret Luciano, Faculty Reader
Keywords:
bioethics
burnout
Lochan
Dev
physician burnout
doctors
mental health
medicine
medical students
care ethics
Abstract:
The high-stress structure of modern medical education is contributing to a growing ethical and public health concern: physician burnout (Dyrbye et al., 2008; Shanafelt et al., 2015). Medical students, entering the healthcare system already burdened by physical, mental, and emotional distress, are placed in environments that often neglect their well-being (Dyrbye et al., 2015). This culture of endurance not only violates the ethics of care, an ethical framework centered on compassion, relational responsibility, and mutual support, but also endangers the quality of patient care. Burned-out physicians are more likely to make errors (West et al., 2006; Shanafelt et al., 2010), experience reduced empathy, and leave the profession prematurely, resulting in long-term consequences for public health. This thesis applies the care ethics framework to analyze how the current model of medical education fails to meet ethical obligations to trainees and, by extension, to patients. Although grounded in the experience of medical students and physicians, this work also takes a broader view by examining how similar patterns of burnout affect other healthcare providers, including nurses, who often experience comparable levels of distress due to hierarchical structures, understaffing, and moral injury. The application the care ethics perspective evaluating the current shortcomings medical training is combined with review of existing literature on medical student burnout to frame how a proposed shift toward humane, care-based reform in healthcare education and institutional culture can support the well-being of all providers and foster a health system rooted in empathy, sustainability, and relational integrity. This thesis uses the ethics of care, a framework grounded in compassion, relational responsibility, and mutual support, to evaluate how the current model of medical education fails to meet its moral obligations to students and, by extension, to patients. The early chapters define burnout, trace its historical emergence in healthcare, and present recent trends in prevalence among students and physicians. A care ethics framework is then introduced to guide the ethical analysis. Subsequent chapters examine contributing factors to burnout, including structural stressors, punitive assessment models, and cultural norms that discourage vulnerability. These are followed by an exploration of the consequences of burnout for students, patients, and healthcare systems. Quantitative data are presented to underscore the systemic nature of burnout across settings, and the thesis culminates in a set of reform recommendations informed by care ethics. These include reevaluating grading structures, improving institutional support systems, and reframing how mental health is addressed in training. The thesis concludes with a broader ethical reflection on what it means to create humane, sustainable educational environments for all healthcare providers.