The ethical foundations of professional resistance

ISSUE: Although it has long been present in medicine and medical education, the growth in the number of instances of resistance by medical trainees around the world, the visibility thereof, and the resulting disruption of medical education have made the grounding of professional resistance a critical concern for all involved. POSITION: The authors argue that professional resistance needs to be understood as being subject to the principles of bioethics that underpin medical professionalism: beneficence, non-malevolence, autonomy, and justice. ARGUMENT: The authors consider the implications of this position in terms of three issues: 1) that becoming a professional and pursuing a professional career requires individuals to yield something of themselves, 2) that a profession should aspire to have and to hold to standards that are higher than those required of it, and 3) the issue of the separation of professional and personal lives. CONCLUSION: All acts of resistance by professionals need to align with the foundational ethical principles of their profession to be legitimately considered professional and they cannot simply be set aside when anger or outrage precipitates acts of resistance.