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The author argues that conflicts of obligation may, but need not, give rise to issues of divided loyalties. Given this, the question then becomes under what circumstances and conditions a simple internal conflict may escalate into the problem of divided loyalties or fiduciary ambiguities. After discussing conflicts of obligation, it is asserted that loyalties are divided only when the demands of the various relationships involved are irreconcilable. As this is an extreme, the major problematic issues fall, then, in between, on multiple loyalties and ambiguous loyalties. How and where multiple loyalties arise, and under what conditions they may become ambiguous loyalties lead to the recognition that moral problems are created by leaving in ambiguity things about the relationships involved that would be better sorted out. Finally the author looks at situations in which physicians are systematically exposed to irresoluble ambiguity.
KIE: Using examples from occupational medicine, sports medicine, and clinical trials, Toulmin discusses two of the moral conflicts he believes are common to all professions: conflicts of obligations and divisions of loyalties. Conflicts of obligation are inherent in all medical practice, the author argues, and cannot be resolved by balancing claims, but only by choosing one obligation over another. Conflicts of loyalty result when a physician's relationships "to two or more individuals, or to two or more institutions, become irreconcilable in ways that force him to choose between them." Along the spectrum of loyalties lie multiple loyalties and ambiguous loyalties, and the latter, if unresolved, create moral ambiguities. Toulmin concludes by identifying characteristics of contemporary American medicine that make it likely that the dilemmas of conflicts of obligation, divided loyalties, and ambiguous relationships will persist.
DIVIDED loyalties. I guess that's a fancy way of saying we're feeling pulled in two directions--sometimes more! When, for example, you want to do what your friends are doing, but you also know you should obey your parents' wishes. It can be pretty confusing. So, what do you do
As I continued praying, the divided loyalty that had disturbed me so much was resolved. The relationship faded naturally away as we gradually went our separate ways. I knew that I had done the right thing in this case, because right before my friend and I stopped dating he told me why he enjoyed our relationship. He said he enjoyed going out with me because he wasn't expected to drink, do drugs, and have sex. He said he had learned from this that he could exclude these activities from his dating experience.
What my friend sensed when we dated was his real selfhood, which is spiritual, made in God's image and likeness. And, you know what He liked that selfhood--so did I. He liked what he was beginning to think and express for the first time in years. For, you see, my friend, too, had a divided loyalty. He had been pulled in two different directions for a long time. The belief that he was a mortal dominated by a mortal body (and had to act like it) was trying to pull him away from learning more of the
We can all have divided loyalties to resolve. But perhaps the biggest decision we come across in our experience is whether to give our loyalty to matter or Spirit. It sure seems like we are made of matter. In reality, though, as Christ Jesus showed us, our selfhood is entirely spiritual. We are made in the image of God, who is Spirit. As we understand our genuine, spiritual identity, we see that we are always governed by our eternal Father-Mother God.
Divided loyalties are a much bigger issue than one individual against another, or parents against children. They show us that we need to choose between matter and Spirit. But when we learn that it is God who demands our loyalty, we see that we can always turn to Him in prayer. We don't need to struggle with divided loyalties, since man is already spiritual