Disagreeing respectfully: embracing complexity facilitates civil discourse.

Canadian medical education journal Pub Date : 2025-11-06 eCollection Date: 2025-11-01 DOI:10.36834/cmej.82086
Ariel Lefkowitz, Jerry M Maniate, Ayelet Kuper
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Abstract

Polarization and incivility are on the rise, negatively affecting collegiality, workplace relationships, morale, and performance at work. The authors argue for the need for civil discourse in medicine and for embracing complexity as an essential component of that civil discourse, facilitating nuanced thinking, respectful dialogue, and greater understanding of other perspectives. This principle of embracing complexity is congruent with the attitude of physicians, who are trained to tolerate uncertainty and to hold and appreciate multiple perspectives in making diagnoses and choosing and proposing treatment plans. This understanding of civil discourse does not amount to moral relativism, whataboutism, or an embracing of both sides of an argument universally, nor does it serve as a cudgel to silence or to perpetuate hegemonic power. Instead, the principles of civil discourse clarify multiple aspects of the boundaries of professional conduct, outlining how physicians can engage in advocacy for patients and communities while maintaining collegial relationships and the perception that they will be safe providers for all patients. The rights of citizens in democracies, including to engage in peaceful protest and to say anything within the bounds of their country's laws governing free speech, do not extend unabbreviated into the lives of professionals, who are limited by the privileges afforded to them and by the responsibilities they have to their patients and colleagues. By embracing complexity and nuance over simplism and slogans, physician colleagues who disagree with one another can communicate respectfully, advocate professionally, and be safe and effective care providers to all patients.

尊重地反对:接受复杂性有助于文明的话语。
两极分化和不文明行为正在上升,对同事关系、职场关系、士气和工作表现产生负面影响。作者认为,医学需要民间话语,并将复杂性作为民间话语的重要组成部分,促进细致入微的思考、尊重的对话和对其他观点的更好理解。这种接受复杂性的原则与医生的态度是一致的,医生在做出诊断、选择和提出治疗计划时,接受的训练是容忍不确定性,并持有和欣赏多种观点。这种对公民话语的理解并不等于道德相对主义,无所谓主义,或者普遍接受争论的双方,也不是作为沉默或延续霸权的棍棒。相反,民事话语原则澄清了职业行为界限的多个方面,概述了医生如何在维护学院关系和他们将是所有患者安全提供者的感知的同时,为患者和社区进行宣传。民主国家公民的权利,包括参与和平抗议和在本国有关言论自由的法律范围内发表任何言论的权利,并没有毫无保留地延伸到专业人员的生活中,专业人员受到赋予他们的特权和他们对病人和同事的责任的限制。通过接受复杂性和细微差别而不是简单主义和口号,意见不同的医生同事可以相互尊重地沟通,专业地倡导,并成为所有患者安全有效的护理提供者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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