2019 Conley Ethics Essay Contest

Background

Established by the John Conley Foundation for Ethics and Philosophy in Medicine, this annual essay contest has been administered by the AMA Journal of Ethics since 2004.

Each spring, the AMA Journal of Ethics poses a question in ethics and professionalism as the topic for the contest. Essays are judged on clarity of writing, responsiveness to questions posed in the essay prompt, and applicability to decisions presented in the case. The author of the best essay receives a prize of $5,000. The author of the winning essay is typically contacted within six weeks of the submission deadline and must be willing, if needed, to revise the essay at the request of AMA Journal of Ethics editorial staff in order to have the work published in the journal.

Please visit here for more detailed information about the contest rules.

Eligibility Requirements

Currently enrolled US medical students (MD or DO), resident physicians or fellows are eligible to submit entries. Entries must not have been previously published in print or electronic format and must not have been submitted to any other publication.

Format Requirements

Essays must not exceed 1,500 words, excluding references. Essays must be written by a single author, typed in Times New Roman 12 with 1.5 spacing.

Cover Page Requirement

The first page of the single Word document file must be the cover page, which must include the author’s name, address, telephone number, e-mail address, medical school (and year in medical school) or specialty training program (and year in training program), as well as the word count of the essay (excluding cover page and references), which must be tabulated as follows: In Word, highlight the essay text only, then on the Review tab in the Proofing group, click the Word Count icon or use Ctrl+Shift+G. This information must be included on the cover page only; essays including the author’s name on other pages of the essay will not be reviewed.

Submission Requirements

Essays must be submitted as one Word document file attached to an e-mail to Mr. Kelly Shaw. The Word document file name must be the author’s last name only. All materials must be received by 5 PM central time on 27 September 2019, as marked by email time-stamp when received by the AMA. Authors who have waited even until 4:55 PM, for example, to submit materials have occasionally been disappointed, due to transmission delays, so please plan accordingly.

Case

How should responsibility for negotiation success be apportioned between unionized clinicians and organizations for which they work?

Dr Y has relocated to a new city to begin her internship. Resident physicians in Dr Y’s training program recently voted to be represented by a labor union.1, 2 Membership is optional, but a common employment contract has been negotiated with the purpose of protecting the interests of all resident physicians, including those not paying membership dues. As Dr Y begins her postgraduate training, the union is negotiating, for the first time since the program’s establishment, terms of the organization’s contracts with its resident physicians.

Dr. Y has so far not made a decision about joining the union. Some senior resident physician peers have encouraged her to join the union,3 emphasizing the need for professional solidarity and for everyone to contribute to prioritization of their common interests. Dr Y and others are hesitant to join the union, in part, because they wonder what, exactly, collective action might require of individual physicians and how it could affect their patients and careers. Short of outright strike, union representatives have suggested that actions could include resident physicians’ refusing to do particular tasks, such as entering critical billing-relevant information into patients’ health records. Dr Y considers that this could be justifiable, as long as patients still get needed care.4 Overall, however, she wonders whether she should join the union.5

References

  1. Scheiber N. Doctors unionize to resist the medical machine. New York Times. January 9, 2016. https://www.nytimes.com/2016/01/10/business/doctors-unionize-to-resist-the-medical-machine.html. Accessed April 3, 2019.
  2. Whatley JR Jr, Kallas EM. Unionization of physicians. Conn Med. 2013;77(5):281-285.
  3. Collier VU, Hojat M, Rattner SL, et al. Correlates of young physicians’ support for unionization to maintain professional influence. Acad Med. 2001;76(10):1039-1044.
  4. Kravitz RL, Linn L, Tennant N, Adkins E, Zawacki B. To strike or not to strike? House-staff attitudes and behaviors during a hospital work action. West J Med. 1990;153(5):515-519.
  5. Toynbee M, Al-Diwani AA, Clacey J, Broome MR. Should junior doctors strike? J Med Ethics. 2016;42(3):167-170.

Essay Prompt

How should responsibility for negotiation success be apportioned between unionized clinicians and organizations for which they work? Which criteria should be used to assess ethical and empirical justification for collective action by clinicians and trainees? Dr Y’s considerations are similar to those of new resident physicians at programs with existing unions, such as one at the University of Michigan (UM House Officers Association 2019). As a non-member who probably benefits overall from the union’s bargaining authority, which factors should Dr Y consider in her decision about whether to join?