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In Reply: Dr Earnest and colleagues correctly state that attending to justice requires a much broader focus than the beneficence, nonmaleficence, and respect for autonomy that a physician is able to demonstrate at the bedside or in the examination room with an individual patient. They also note that different skills and behaviors are required to address injustice in the health system, a point with which we do not take issue.

What does merit further discussion, however, is the degree of educational redesign that will be required to prepare physicians to function "as a citizen, an advocate, and an activist." It could be argued that individuals are already being selected for medical schools from a pool of applicants who have developed these skills to a high degree, as indicated by their prior actions and their future intentions. This is illustrated by data on medical school applicants showing that a significant proportion . . . [Full Text of this Article]

Darrell G. Kirch, MD
dgkirch@aamc.org

David J. Vernon, BA
Association of American Medical Colleges
Washington, DC

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RELATED LETTER

Professional Behaviors of Physicians and Pursuing Social Justice
Mark Earnest, Shale Wong, and Steve Federico
JAMA. 2009;302(12):1269.
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