Dr. David Doukas
Director, James A. Knight Chair of Humanities and Ethics in Medicine
Areas of Expertise
Biography
David John Doukas, MD is the James A. Knight Chair of Humanities and Ethics in Medicine, and Professor of Family and Community Medicine at Tulane University School of Medicine, where he directs the Program on Medical Ethics and Human Values. He also currently serves as President of the Academy for Professionalism in Health Care, an organization devoted to enhancing professionalism through ethics and humanities education. He teaches and writes in the areas of professionalism, primary care bioethics, human genetics, and end-of-life decision-making.
Prior to accepting his current responsibilities, Professor Doukas served on the faculty of Georgetown University, the University of Michigan, the University of Pennsylvania, and the University of Louisville teaching and writing in the areas of professionalism, clinical ethics, primary care bioethics, human genetics, and end-of-life decision-making. He is interested in understanding the ethical implications of value judgments that patients and physicians use in the informed consent process, and has written on the need to better understand the ethical obligations of physicians in working with families with an emphasis on better articulating the boundaries of the physician-family relationship. He is the author of the concept termed the family covenant (1991), a healthcare agreement between a health provider and entire family that sets out to address proactively issues revolving around individual and family claims to medical information. He is the co-developer and author of the Values History (1988) as a method for eliciting the values and advance directives of patients toward life-prolonging care. The Values History has been widely cited as a valuable model for identifying relevant patient values important in end-of-life care decision-making. He co-authored the book, Planning for Uncertainty (Johns Hopkins University Press, 1993, 2ndedition 2007) with William Reichel, M.D., which examines the evaluation of patient values and their relevance to advance directive selection.
Professor Doukas’ degrees include a B.A. in Biology and Religious Studies from the University of Virginia and an M.D. from Georgetown University School of Medicine. After his Family Practice residency (University of Kentucky), he completed a Post-Doctoral Fellowship in Bioethics (1986-87) at the Joseph and Rose Kennedy Institute of Ethics at Georgetown University and the Franklin Square Hospital Center.
Education
Georgetown University Joseph and Rose Kennedy Institute of Ethic
University of Kentucky
Georgetown University, School of Medicine
University of Virginia
Articles
Promoting Professionalism Through Virtue Ethics
2019
It is intrinsic to the social covenant that physicians are agents in whom we can implicitly expect fidelity, and as such, we deplore reports of sexual abuse, criminal opioid prescribing, and unnecessary invasive surgeries (Dubois et al. 2019) Not only are patients harmed, but the very fabric of this social covenant is also damaged in the process. While some physicians may have psychological or substance abuse disorders, others likely have defects of character. Rather than discuss opioid/procedure oversight or the wisdom of chaperoned examinations, this commentary focuses on the character of those physicians, addressing something that is likely not discussed often when it comes to malevolent physicians who practice wrongs against their patients-education. Nevertheless, it is unfortunate that the word education only appears four times in the text of this article. Medical education is a lifelong process. Medical…
Preventing Egregious Ethical Violations in Medical Practice: Evidence-Informed Recommendations from a Multidisciplinary Working Group
2018
This article reports the consensus recommendations of a working group that was convened at the end of a four-year research project funded by the National Institutes of Health that examined 280 cases of egregious ethical violations in medical practice. The group reviewed data from the parent project, as well as other research on sexual abuse of patients, criminal prescribing of controlled substances, and unnecessary invasive procedures that were prosecuted as fraud. The working group embraced the goals of making such violations significantly less frequent and, when they do occur, identifying them sooner and taking necessary steps to ensure they are not repeated. Following review of data and previously published recommendations, the working group developed 10 recommendations that provide a starting point to meet these goals. Recommendations address leadership, oversight, tracking, disciplinary actions, education of patients, partnerships with law enforcement, further research and related matters. The working group recognized the need for further refinement of the recommendations to ensure feasibility and appropriate balance between protection of patients and fairness to physicians. While full implementation of appropriate measures will require time and study, we believe it is urgent to take visible actions to acknowledge and address the problem at hand.
Why Pull the Arrow When You Cannot See the Target? Framing Professionalism Goals in Medical Education
2018
Professionalism is essential for a successful physician–patient relationship and widely acknowledged as an intrinsic and important component of medical education for learners at all levels, from medical school to residency to continuing medical education. The problem is defining the educational end points for learners and then determining how to assess these outcomes. This Invited Commentary focuses on what medical educators can and should do to refine the vision of professionalism in medical education. The authors propose a multistep process in which learners, educators, and the public are engaged in articulating clearly and definitively the end points of professionalism education.
