The concept of moral typecasting states that one who has a position of moral agency, the capacity of doing good or evil onto others, is less likely to experience moral patiency, the state of being the target of someone else’s good or evil. One study sought to analyze the theory of moral typecasting in medicine (1). They asked the question of how physicians are viewed relative to other individuals; are they moral agents, patients, or both?
They did this by taking 681 participants and asking them to rank the mental capacities of 12 targets: 3 doctors (neurosurgeon, cardiologist, primary care physician), a nurse, 2 workers (factory worker, bank teller), 3 patients (cancer patient, asthma patient, heart attack patient), a persistent vegetative state (PVS) patient, God, and a 10 year-old girl. Targets were ranked based on their perceived mental capacities (planning for the future, exerting self-control, remembering details, and thinking), as well as their experiences (feelings of fear, pain, embarrassment, hunger).
This study found that doctors of all 3 specialties were rated as equal to God in their capacity to think, exert self-control, remember details, and plan for the future, all characteristics that contribute to moral agency. Meanwhile, doctors were ranked as the least capable of experiencing emotion out of all able bodied humans listed. There was no difference in ratings amongst different medical specialties.
Although this is one study, it demonstrates a clear disconnect in how physicians are viewed relative to people with other professions, and even relative to other healthcare workers (ex; nurses in this study). A previous study demonstrated that people view individuals who are known to help others, such as Martin Luther King Jr. and Mother Theresa, as less sensitive to experiences of pain, fear, etc than the average individual (2). This study also found that people are more willing to inflict harm on individuals who have helped others, and thus have high moral agency, rather than individuals who have done less ‘good’. This is likely due to the fact that people believe these individuals to be better equipped to cope with harm than the average person.
As a result of this dichotomous way of viewing the world, it appears that public perception towards physicians as ‘God-like’ lends to the idea that they are less likely to feel pain and weakness than the general population. If this is true, it is no wonder why we encounter so many physicians who embody the ‘God complex’ in their everyday lives.
Despite these perceptions, it is clear that the burden of moral agency comes at a great cost to the mental wellbeing of many physicians today. Physician burnout is an epidemic that continues to plague the healthcare system. Much of this burnout can be attributed to the moral injury that physicians experience early in their training, as insurance companies, social determinants, and other external factors limit their ability to meet patients’ needs, and thus exert their moral agency. Additionally, despite good intentions and extensive training, complications can always arise that can have unintended effects on innocent people. As much as 84% of surgeons have reported a combination of anxiety, guilt, sadness, shame, and anger in response to adverse events, although there is little discourse on the topic of physician and trainee regret (3).
In short, moral typecasting is an interesting theory that may play a role in the psychological strain placed on physicians in our current healthcare system. Further discourse on physician regret and burnout is needed to humanize physicians in the public sphere and work towards institutional change.
References
- Goranson A, Sheeran P, Katz J, Gray K. Doctors are seen as Godlike: Moral typecasting in medicine. Soc Sci Med. 2020 Aug;258:113008. doi: 10.1016/j.socscimed.2020.113008. Epub 2020 May 25. PMID: 32466848.
- Heather M. Gray et al., Dimensions of Mind Perception. Science 315,619-619 (2007). DOI:10.1126/science.1134475
- Han K, Bohnen JD, Peponis T, et al. The surgeon as the second victim? Results of the Boston Intraoperative Adverse Events Surgeons’ Attitude (BISA) Study. J Am Coll Surg. 2017;224(6):1048-1056.
Cover Image Source: Julia O’Brien, AMA J Ethics. 2025;27(3):E216-221.
Dalia Koujah is a third year medical student at the University of Arizona College of Medicine-Phoenix. She graduated from UCSD, majoring in Neuroscience and minoring in Human Developmental Sciences when she wasn’t at the beach. Dalia enjoys painting, trail running, and reading in her free time. Please feel free to reach out at dkoujah@arizona.edu.