Ethics and Professionalism
Michael Montagne, PhD Robert L McCarthy, PhD
The quest to construct systematically an ethical framework for Western civilization was begun over 2000 years ago by Socrates. He approached ethics as a science, as being “governed by principles of universal validity, so that what was good for one was good for all, and what was my neighbor’s duty was my duty also.”1 However, acceptance of the Socratic approach has proved burdensome. After 2000 years of effort, humankind universally adheres to not even one ethical principle. No set of ethical principles, no matter how carefully thought out or how well constructed, can provide the individual professional with guidance for each decision about clients, peers, or society. There are people who believe that because each situation is different, each decision requires separate analysis of possible outcomes from different actions and the weighing of right and wrong. Regardless of one’s stance or approach, however, the health professional in today’s society needs continual selfexamination of professional duties and ethical principles to be prepared for the conflicts and dilemmas they will face.
“They may at least act as rules-of-thumb for handling easy cases. They may at least summarize ethical reasoning that has gone before by others who have found themselves in somewhat similar situations. They may at least serve as guidelines for formulating thinking about the problem at hand.”4
In this discussion, professional ethics is used only to denote “the profession’s interpretation of the will of society for the conduct of the members of that profession augmented by the special knowledge that only the members of the profession possess.”2 In other contexts, the term might be used to denote those ethical principles to which society believes any individual claiming professional status should subscribe. What is to be gained by development of a set of ethical principles, or a code of ethics (Fig 31), by a profession to which it expects its members to abide? First, a code of ethics makes the decision-making process more efficient. In opposition to situational ethicists, Veatch claims: Yet if those who must resolve the ever-increasing ethical dilemmas in medicine—including patients, family members, physicians, nurses, hospital administrators, and public policy-makers—treat every case as something entirely fresh, entirely novel, they will have lost perhaps the best way of reaching solutions: to understand the general principles of ethics and face each new situation from a systematic ethical stance.3
Second, individual professionals occasionally may need guidelines for directing their professional behavior. Each decision made by a professional requires calling upon a store of technological information as well as the individual’s own sense of right and wrong. Almost assuredly, all professionals will be confronted with situations that they have never considered in great detail. Where one can find no apparent theological or personal ethical principles to apply, one might turn to professional ethics for guidance. Finally, professional ethics establish a pattern of behavior that clients come to expect from members of the profession. Once a consistent pattern of behavior is discerned by clients, they expect that behavior to remain constant, and their expectations become part of the relationship they establish with the professional. To better understand the role of and necessity for ethics in professions, one must first look at the characteristics of professions.
The first characteristic of a professional is possession of a specialized body of knowledge; using this body of knowledge enables the practitioner to perform a highly useful social function. All lawful occupations provide some positive benefit to society and are based on specialized knowledge. The professions generally are more socially useful...