Erosion of the ‘ethical’ doctor-patient relationship and the rise of physician burn-out
Why this work is in the frame
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Bibliographic record
Abstract
This paper examines the topic of physician burn-out from a philosophical lens. We explore the question of how the rise of physician burn-out may be related to an underlying erosion of meaning in medicine, characterised by the breakdown of the intersubjective relationship between doctors and patients. We argue that while commonly cited strategies for addressing burnout-including promoting work-life integration, cultivating workplace community, and fostering resilience-are critical for enhancing physician well-being, the common thread linking these approaches is that each identifies the physician as the primary locus of intervention. We propose that physician-centric approaches alone may be insufficient in addressing burnout, as the work might also involve shifting our attention to the intersubjective space that exists between the physician and the patient. To further elucidate the connection between intersubjectivity and the creation of meaning in medicine, we call on twentieth-century philosopher Emmanuel Levinas. Applying Levinas's philosophy to the clinical context, we discuss the phenomenon of 'depersonalisation' and ask whether, rather than a mere consequence of burnout, depersonalisation might be a core cause of this condition. With these points we shed light on an idea that is relatively absent from the burn-out literature: that a person-oriented approach is vital not only for patient well-being but for physician wellness as well, as a process that 'de-personalizes' patients might result in a simultaneous dehumanisation of physicians themselves. Drawing inspiration from Levinas, we explore how a reorientation towards the intersubjective, dialogical dimension of the doctor-patient dyad could serve as one important ingredient in healing not only the patient, but the physician as well.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it