Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Being PerfecT in Healthcare 

Plato, Greek philosopher. A disciple of Socrates and the teacher of Aristotle, he founded the Academy in Athens. This is his statue, located before the Academy of Athens, Greece.


Moral questions often arise in healthcare. Contemplating how our efforts might translate into the most good deserves our thoughtful consideration. 

We both recently read the book “How to be PerfecT: The correct answer to every moral question,” by Michael Schur. We both LOVED it–lots of laughter and learning. 


The book begins by reminding us that moral philosophy urges us to regularly ask the following questions: What are we doing? Why are we doing it? Is there something else we can be doing that is better? Why would it be better? 


The book poses funny, if not bizarre, questions and then answers them with the teachings of several prominent philosophies / philosophers, including Aristotle’s virtue ethics, utilitarianism, and Kant’s deontology. We’ll list them below and add wacky healthcare-related questions that rose to our consciousness when reading this book. 


From the book: Is it OK to punch your friend in the face? OF COURSE NOT! 

Healthcare: Is it ok to be disrespectful to patients? OF COURSE NOT! 


From the book: Do I let this runaway trolley hit and kill five people, or should I pull this lever to switch the track so that instead only one person is killed? 

Healthcare: For a an unresponsive patient who expressed wishes to die without any life-sustaining interventions, should I keep them alive longer to give time for their family to travel to visit to say goodbye? 


From the book: Is it ok to tell my friend that she looks great when she’s wearing an ugly shirt as she heads out to an important job interview? 

Healthcare: Is it ok to give your patient a “harmless” prescription as placebo when they’re insisting on getting treatment for something that will resolve on its own and there’s no effective therapy available? 


From the book: Do I need to return the grocery cart to the rack or the front of the store after I finish shopping? 

Healthcare: Do I need to respond to a patient question or request that I notice on EPIC over the weekend when I’m not on call? 


From the book: Should I run into a burning building and try to save everyone who’s captured inside? 

Healthcare: Should I confront my patient who makes a disparaging or insensitive comment about a member of my team? 


From the book: If the CEO of the company is morally problematic, may I still buy his company’s most delicious chicken sandwich? 

Healthcare: Should I still prescribe medications made by a drug company that knowingly promoted opioids that caused thousands of overdose deaths? 


From the book: I screwed up! Do I have to say I’m sorry? ABSOLUTELY! ALWAYS! 

Healthcare: I screwed up! Do I have to say I’m sorry? ABSOLUTELY! ALWAYS! 


This book will promote lots of reflection. At this time, with all of the challenges in healthcare and because we all need to laugh more, we suggest you add this to your summer reading list. In the book, the author jokingly tries to coin the term “moral exhaustion” so that he can be considered a preeminent philosopher. Kidding aside, contemporary medicine often feels morally exhausting and this book may serve to arm you with an approach to consider for some of the strange and baffling questions that we will continue to encounter. 


Of the many things that we will remember from this book, the three that stood out to us were: 

1. Keep trying to get it right. 

2. Apologize quickly and sincerely. 

3. If we can ask ourselves moral questions, we are luckier than most people on the planet. This luck means that we owe more kindness, warmth, empathy, and generosity to others.   




This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.