Jaded: Institutional oppression and moral damage in healthcare

This dissertation combines healthcare ethics, metaethics, moral psychology, moral epistemology, and social and political philosophy with an emphasis on professionalism in healthcare. In it, I explore the question When it is said that someone is "jaded," what does this mean morally? I focus in particular on how becoming jaded can affect healthcare professionals, and I argue that jading is a moral problem in the context of healthcare for two reasons. First, professionals who care for society's most vulnerable members get morally damaged when they get jaded. Second, this moral damage can affect patient care and collegiality among professionals for two reasons: jaded professionals' conceptions of what they're responsible for narrows and jaded professionals narrow the scope of moral particulars of situations they see as reasons to act in the service of others. I characterize jading as a concept that best describes a process of moral motivational erosion. I argue that an internalist, cognitivist theory of moral motivation best accommodates the idea that moral motivation is not an "all-or-none" phenomenon but one which admits of degrees, and also best accommodates the central role moral perception plays in healthcare professionals' abilities to be morally responsive to patients and colleagues. I then apply this theory to describe forms of moral damage (loss of self-respect, alienation, and callousness) healthcare professionals suffer when they work in conditions of institutional oppression. I suggest that resolving the problem of jading requires ameliorating conditions of oppression in healthcare education and in the healthcare workplace.