@article{ART003383351},
author={Won-Bae Chang},
title={Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation},
journal={Korean Journal of Medical Ethics },
issn={2005-8284},
year={2026},
volume={29},
number={3},
pages={223-237}
TY - JOUR
AU - Won-Bae Chang
TI - Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation
JO - Korean Journal of Medical Ethics
PY - 2026
VL - 29
IS - 3
PB - The Korean Society For Medical Ethics
SP - 223
EP - 237
SN - 2005-8284
AB - This article examines the crisis in high-risk essential healthcare from a clinician-centered perspective.
Although workforce shortages, inadequate compensation, regional disparities, and legal liabilityare often cited, these structural factors fail to capture clinicians’ core ethical experiences. In highrisksettings, clinicians who aspire to high ethical standards repeatedly face systemic constraintsthat prevent them from realizing their professional ideals. This article interprets moral injury inthis context as damage to clinicians’ moral identity: an erosion of their self-understanding as goodclinicians and of their belief that this self-understanding can be enacted. Such damage manifestsrelationally through either internalization (characterized by guilt, shame, and self-blame) orexternalization (expressed through anger, betrayal, and distrust). The article argues that therapeuticalliance can recontextualize internalized moral injury within a shared clinical goal, while a fair thirdpartyevaluative structure can prevent externalized moral injury from turning the patient–clinicianrelationship into a locus of conflict. Contemporary provider ethics must therefore move beyondsacrifice-based professionalism to focus on relational and procedural frameworks that sustainclinician integrity.
KW - moral injury;moral distress;moral identity;therapeutic alliance;burnout;medical professionalism
DO -
UR -
ER -
Won-Bae Chang. (2026). Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation. Korean Journal of Medical Ethics , 29(3), 223-237.
Won-Bae Chang. 2026, "Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation", Korean Journal of Medical Ethics , vol.29, no.3 pp.223-237.
Won-Bae Chang "Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation" Korean Journal of Medical Ethics 29.3 pp.223-237 (2026) : 223.
Won-Bae Chang. Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation. 2026; 29(3), 223-237.
Won-Bae Chang. "Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation" Korean Journal of Medical Ethics 29, no.3 (2026) : 223-237.
Won-Bae Chang. Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation. Korean Journal of Medical Ethics , 29(3), 223-237.
Won-Bae Chang. Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation. Korean Journal of Medical Ethics . 2026; 29(3) 223-237.
Won-Bae Chang. Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation. 2026; 29(3), 223-237.
Won-Bae Chang. "Ethical Restoration in High-Risk Essential Healthcare: Reconstructing Contemporary Provider Ethics Through Therapeutic Alliance and Third-Party Evaluation" Korean Journal of Medical Ethics 29, no.3 (2026) : 223-237.
