Catherine Hale¹
1 University of Warwick

Phronesis or practical wisdom is a concept of making ethically wise decisions informed by accumulated collective wisdom gained through previous practice dilemmas and decisions. This paper responds to a call from medical practice to be provided with the means to apply phronesis to their decision-making and appropriately assess that ability. In responding to this call, research collected narratives of doctors’ in answer to the question: What does it means for doctors to make ethically wise decisions for patients and their communities and how is it possible to assess this? 

This is the first empirical study of self-assessment and reflection of wise decision making by Drs, a UK AHRC funded three-year project. 131 Drs/medical students were interviewed, and in-depth analyses of their self-assessment and reflection conducted to understand the virtues underpinning medical wisdom. The interviewees were at different career stages and we used a semi-structured, qualitative methodology. Interviews took up to 45 minutes and were them transcribed and analysed using both manual coding and NVivo. 

From this the fifteen virtue continua appear to underpin the professional ethical decision- making systems that Drs use to make wise decisions and also to self-assess, utilise dialogical learning and reflect upon ethical decisions made. The research reveals that experience alone does not make doctors wise, it is the process of self-assessment, reflection, and peer dialogue with experience or simulated experience that leads to higher level decision making. 

The fifteen virtue continua that emerged are conveyed in a seven-part film series and app- available on phronesis website. This paper provides evidence that phronesis can be cultivated through reflection and self and peer assessment as well as dialogue based on a three-year evaluation of this unique research. 

References (maximum three) 

Conroy M, Malik A, Hale C, et al (2021) Using practical wisdom to facilitate ethical decision- making: a major empirical study of phronesis in the decision narratives of doctors BMC Medical Ethics 22, Article number 16 (2021) DOI: https://doi.org/10.1186/s12910-021-00581- y 

Malik A, Weir C, Conroy M, Hale C & Turner C (2020) Phronesis and the Medical Community Follow-on Impact and Engagement Project. AHRC Final Report and UoB publication 51 pages 

https://www.birmingham.ac.uk/Documents/college-social-sciences/social- policy/phronesis/impact-assessment-phronesis.pdf 

Conroy M, Malik A, Weir C, Hale C, et al (2018) Phronesis in Medical Decision Making: Medical Leadership, Virtue Ethics and Practical Wisdom. AHRC Final Report and UoB publication 180 pages 

https://www.birmingham.ac.uk/Documents/college-social-sciences/social- policy/phronesis/phronesis-in-medical-decision-making.pdf 

Hale C (2018) The Phronesis Foundation Teaching Resources- Tutor Notes and Student Guide: Teaching Materials for Ethical Wise Decisions in Medicine- Available to subscribing institutions, companies and individuals at https://www.thephronesisfoundation.com/