Ethics of Care: Philosophical Propaedeutics as a Therapy for Emotional Burnout in Medicine

Abstract

The purpose of this article is to comprehend the reasons for the exponential growth and specificity of «burnout» of medical personnel during the Covid-19 pandemic and to substantiate the therapeutic potential of philosophy based on P. Ricoeur’s narrative identity theory. The pandemic has forced a new way of looking at the attitude to time, convincing us that in general we are not badly prepared for emergency medical care, but we are not coping with the problem in the long run. An example of this is the ineffectiveness of the treatment of many chronic diseases against the background of covid, which inscribe the disease in the time limits of the individual life. The temporality of patient care is partly determined by the nature of the organization of the health care worker's work — its routinization and the emphasis placed on individual performance evaluation. This artificially creates conditions for the actual dilution of professional teams, creating competition between doctors, between services and between patients. Time turns out to be fragmented, and treatment, developed mainly for the short term, is reduced to a certain sequence of actions, sometimes without any real coherence. As a result of the disruption of temporality, the identity of the subject caring for the patient is blurred, the “meaning of the profession” is also questioned. The risks of burnout associated with a decrease in the level of responsibility of a medical worker and an increase in the probability of professional errors, require an understanding of the causes of subjective suffering experienced by medical workers and the construction of a collective narrative. Its necessity is also explained by the need to ensure the protection of the medical worker in the face of both the administration and the patient community, which requires a return to the collective history and the creation of a system of internal and external protective mechanisms of the medical community. This requirement, based on the public recognition of the value of medical staff work, is well respected in several leading Western countries and completely ignored in Russia.