By Mary Gannon Kaufmann, MS, RDN, MA, BCC
When we consider ethics for a health professional, each association presents a code of ethics to guide professional behavior, for example, the Code of Ethics for Nutrition & Dietetics Professionals from 2018[i]. While these guidelines or rubrics are important in ensuring that society’s common and individual good are served, dietitians, having ethical guidelines is not enough. We need to form professionals, aka ethical agents, to enact these norms as they care for real people. In fact, working through the stresses and demands of caring for vulnerable patients helps the dietitian to grow in virtue or good patterns of generous living. Practicing morally and ethically involves more than just knowing what the bare minimum is required or what the code says. It is about being able to live to be perfected in your craft, “to be directed in a moderate, stable, responsible, motivationally creative and rightly ordered manner towards the achievement of the good.”[ii] Contact with a knowledgeable and virtuous practitioner heals and motivates patients to a healthy lifestyle.
Aquinas, a deep philosophical thinker from the early Middle Ages, called a virtue “a good quality of mind by which one lives righteously.”[iii] Good patterns of mind, or virtues, empower health professionals “to act with greater perception, promptness, facility, responsibility, and pleasure in exercising their talents and applying these general principles, laws [Code of Ethics] to particular situations,” according to David Beauregard, in Virtue in Bioethics.[iv] Effective practitioners follow the standards of practice for their discipline and cultivate interior dispositions that perfect their impact on patients. When was the last time you felt this pleasure in exercising your craft?
For instance, a Registered Dietitian who adheres to all the guidelines in “Nutrition and Physical Activity Interventions for Adults in the General Population: A Position Paper of the Academy of Nutrition and Dietetics and the American Council on Exercise”[v] or the four-part Code of Ethics described earlierwill be merely adequate, but not good or excellent, without applying virtue. In this context, the practitioner simply executes what they know without that “inner disposition toward the perfection of [dietetics], which involves the development of knowledge, talent, sensitivity, patience, and skill actively directed toward the good of the patient.[vi]” Don’t you want to grow beyond being a mechanical practitioner?
What essential virtues are specific to being an ethical healthcare provider or Registered Dietitian- those involved in making bioethical and medical decisions and applying the appropriate rules[vii] to patient care? A primary virtue is faith. Interestingly, understanding faith within lifestyle medicine is best illustrated by examining what occurs when secular individuals live without exercising faith. Often, these individuals perceive suffering as pointless, meaningless, and absurd, viewing life as something they must control completely.[viii] A patient or practitioner with this mindset may believe that if clients merely follow through, eat the right foods, take the appropriate supplements, and maintain regular exercise patterns, their metabolic struggles will cease, leading to optimal health. Not always. However, when individuals cultivate an internal disposition to view the world through the lens of faith, they recognize their call to exercise dominion over themselves in a more respectful, cooperative, and harmonious manner, embracing it as a form of stewardship.[ix]
With faith, suffering is viewed differently. Even with the best palliative care, suffering persists in this life and can be approached and understood as a part of life that holds meaning, being mysterious, redemptive, and even formative in this vale of soul-making. Interestingly, to fully apply the Code of Ethics of Nutrition & Dietetic Professionals, practitioners must become moral agents, exercise faith, and embody cooperative, harmonious, yet respectful wellness, along with four other virtues for healthcare professionals that we will explore in the next reflection.
[i] Code of Ethics for the Nutrition and Dietetics Profession, Academy of Nutrition and Dietetics, Published 2018
[ii] Beauregard D, Virtue in Bioethics, in Catholic Health Care Ethics, A Manual for Practitioners Third Edition, Edited by Edward Furton, The National Catholic Bioethics Center, Philadelphia, 2020, p 3.24
[iii] Thomas Aquinas, Summa theologiae I-II.55.4
[iv] Beauregard D, 2020, p 3.22
[v] Nutrition and Physical Activity Interventions for Adults in the General Population: A Position Paper of the Academy of Nutrition and Dietetics and the American Council on Exercise, https://www.eatrightpro.org/-/media/files/eatrightpro/practice/academy-positions/nutrition-and-physical-activity-inteventions-for-adults-in-the-general-population.pdf?rev=19e6e2fefd724a6e9e16ada2cd9f8a10
[vi] Beauregard 2020, 3.25
[vii] Beauregard 2020. 3/25
[viii] Beauregard, 2020, 3.25
[ix] Beauregard 2020, 3.26