The present book addresses the background, rationale, general structure, and particular aims and arguments characterizing our third and last volume about "humor" and "cruelty". A guiding foray is provided into the vast expert literature that can be retrieved in the Western humanities and social sciences on these two terms. Pivotal thinkers and crucial notions are duly identified, highlighted, and examined. Apposite subsidiary references are also included, especially with regard to psychodynamics and clinical psychology, existentialism, feminism, liberalism, Marxism, and representative recent (...) studies in the philosophy of humor and its cognates. The stage is thus set for the exploration and assessment of the conflicts between humor and cruelty unfolding in Part 2 of Volume 3. Being the philosophical terminus of our entire research project, Volume 3 counterbalances, complements, and, occasionally, complexifies the numerous forms of mutual cooperation between humor and cruelty that the preceding Volume 2 had unearthed and discussed. (shrink)

Three ethical conflicts in particular are paradigmatic of what we define as “clerkship ethics.” First, a distinction that differentiates the clerkship student from the practicing physician involves the student’s principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student (...) is left with a more ambiguous set of choices. Second, evaluative scrutiny during clinical clerkships often forces medical students to balance doing what is morally fitting against the perceived expectations of the medical teams in which they work. Third and finally, a deeply entrenched culture of medical hierarchy presents a particular challenge to innovation and improvement in ethics education during the clerkship years. Students regard faculty as exemplars, but are not provided with the tools to assess when technical medical competence is not matched by moral competence; moreover, these faculty are unlikely to have experienced the ethics education in which students are asked to demonstrate mastery. (shrink)

Health care professionals assigned to critical care are confronted on a daily basis with particularly trying situations. Their hard work conditions can become anxiety-provoking, affect their physical and/or psychological condition, decrease their performance and increase their absenteeism rate at work. To face this particularly stressful and sometimes depressing context, some professionals fall back on “gallows humour”, a sort of black humour with a morbid overtone, which is likely to shock certain people. Although gallows humour is very widespread, its use in (...) critical care is extremely controversial and most of the time reprimanded by professional orders. Based on the codes of ethics that govern them, professional orders assume that gallows humour violates the duties and responsibilities of their members towards their patients, rejecting its use straightaway. In this article, we contest the categorical rejection of gallows humour in critical care. We adopt a consequentialist perspective based on the study of scientific literature on the benefits of using humour in the workplace, to defend its ethical acceptability. By enabling us to be better prepared to provide care despite the tragic events experienced by professionals, we will see how the use of gallows humour can ultimately have a positive effect on patients. A consequentialist ethics is not only interested in maximizing the benefits of gallows humour but also in reducing the risk of harm to others related to its use. This important criterion will therefore lead us to define the terms and suggest certain conditions that must be respected for an ethical use of this important defense mechanism by health care professionals in critical care. (shrink)