Abstract
The authors demonstrate how the goals and values of medicine may be better reached if a peace leadership mindset serves as the foundation for physician professional identity formation. And because much of the professional identity of new physicians, residents, and fellows comes through role-modelling, any educational intervention that intends to influence professional identity formation must also include robust faculty and continuing professional development. Peace leadership is urgently attractive to the medical educator and faculty and continuing professional education developer because it provides concepts and tools to address a pervasive and growing aspect of the profession of medicine beneficially and directly, from education to practice, that remains intractable: adversarial attitudes and conflict. These make an impact on much of medical care and exact a heavy toll on all involved.
The Red Cross can and must transmit the spirit of peace by which its members give an example of selfless assistance, by which the barriers separating classes, parties, races and nations are removed. For peace to be maintained, it is certainly not sufficient for a peace treaty to be signed: peace must take root in the hearts of men and women. (Meuli, 1970, p. 83)
Lategan and van Zyl (2019) argue that medical personnel, including doctors, nurses, and therapists, should be considered peace leaders because “they promote and support the vulnerable in a community context” (p. 174). This points to an important aspect of the role of health professionals, to respect, attend to, and bear witness to the essence of the human experience: being born, suffering, and dying. Attending to people in their vulnerability must be done with a set of publicly shared values where there are professional, not only personal, consequences for not upholding them. Otherwise, we risk venturing down dangerous roads, for example, eugenics, unethical human subject experimentation, physician facilitation of state-sanctioned torture, and limiting or revoking personal liberty.
In what follows, we will present the case that peace leadership promises a framework to form and maintain the professional identity of all physicians in all aspects of medical practice. The tools and the mindsets that emerge from peace leadership studies were forged by diplomatic leaders and conflict workers managing complexity, where decisions are immediate, important, and highly impactful on human welfare. The healthcare system and road to physicianship is also complex, and the decisions that physicians make are immediate, important, and have a high impact on human welfare. The work of physicians is fundamentally humanitarian, driven by important values to meet the most basic needs and respect the inherent dignity of all human beings, especially the most vulnerable. Medical professionals can learn from peace leadership studies an approach to understanding and managing the devastating effects of conflict: in particular, the tools of authentic leadership, recursive thinking, and transcendent problem solving. Physicians are ideally suited to be peace leaders in healthcare spaces, and the community at large, because of their social status, social capital, and ability to influence people within and outside of medical practice; as such they are well situated to be catalysts for much needed change in medicine.
We begin by recognizing that peace leadership offers tools and mindsets to address conflict. Peace studies emerged as a discipline within political science to address issues of international conflict and the resultant violence (Spreitzer, 2007). Galtung (2004) contends that the aim of peace is violence prevention, not conflict prevention (p. 2). Because conflict is inherent in the human condition, the prevention of conflict is a nonsensical aim. The conception of peace as violence prevention is meaningful because violence is an assault on human flourishing. Human flourishing is the goal of all peace work. Lipman-Blumen (2014, as cited in Campbell & van Zyl, 2019) explains,
Peace...must be broadly defined to mean far more than the absence of war. Peace must stand on a foundation of justice, equality, sustainability, and all the other societal and human needs required for the world's citizenry to live productively, harmoniously and happily. (p. 5)
Chinn (2004, as cited in Campbell & van Zyl, 2019) formulates peace as the motivation for action, the process for getting to peace, and the outcome of human flourishing (p. 6). Chinn's (2004, as cited in Campbell & van Zyl, 2019) particularization of peace as intent, process, and outcome is particularly useful to consider in the context of medical practice,
The intention of peace is the commitment to chosen values and actions that consistently bring about harmony, trust and constructive solutions to differences and disagreements. The process of peace is the interactions that flow from the commitment. The outcome of peace is relations that give rise to ongoing harmony, trust, and effective solutions to problems. Peace requires that your chosen values guide your actions. Peace is the means and the end, the process and the product. (p. 6)
Key Terms in this Chapter
Authentic Peace Leadership: A leadership style centered on the transformation of a leader through self-development toward a culture of peace and exemplified by humility, empathy, integrity, and courage.
Undergraduate Medical Education: In the US, the four-year period of medical school during which a student learns the basic science and clinical foundations of medicine and culminates in a medical degree.
Transcendent Problem Solving: A method for addressing conflict that uses creativity and incremental iterations to solve bigger problems.
Recursive Thinking: A way of understanding cause and effect that accounts for the ways that the actions, arguments, and narratives of the participants shape the chain of events.
Continuing Professional Development: Programing and resources for professionals towards maintenance, enhancement, and development of knowledge and skills necessary to continue practice in a professional context (e.g., medicine, nursing, law, and engineering).
Professional Identity Formation: A process of internalizing the values, norms, and characteristics of a profession resulting in the individual thinking, acting, and feeling similarly to others in their profession.
Faculty Development: Programming and resources for faculty towards their professional development and advancement as educators, scholars, and leaders in academia.
Residency: Specialized training after undergraduate medical education where the newly graduated physician learns to practice in a specific area of medicine e.g., pediatrics, surgery, or dermatology.