The Anger Paradox: How Angry Should Physicians Be?

Abstract

This article starts from the question: how angry should physicians be? Since the literature so far has mostly focused on patient anger, we endeavor to turn bioethical attention to physician anger instead. After specifying our central question in four different ways-in terms of its normativity, its use of the term "physicians," the implied patient-directed nature of this anger, and the difference between feeling and behaving angrily-we posit the anger paradox (AP) to help guide our argument. We discuss whether anger might damage the therapeutic relationship, or whether it could be a necessary expression of care. We follow three steps in looking at whether physicians can feel, should feel, or should express anger. We complicate the question of care and its objects by introducing Frankfurt's distinction between first- and second-order desires. Finally, we look at the distinction between apt and appropriate anger, concluding that while physician anger can sometimes be apt, it is never appropriate to express toward patients.