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Seven Theses on Professional Ethics

Augusto Hortal Alonso
Definition of a profession In some way every job is a profession, but not every job is a profession in its full sense. Recently there has been a trend towards the professionalisation of work; some jobs have become more professionalised than others. Today practically everyone wants to be a professional. Therefore, the task of defining what a profession is may turn into a source of offence for those who are not included under the given definition of profession1. On the one hand, if one has an excessively restricted concept of profession, the claims of some groups to be considered as true professionals may seem to be disqualified ex definitione. On the other hand, if every stable occupational activity that someone does to earn money is considered a profession, then we have such a broad concept that hardly any concrete statement could be made about it. Professional ethics, understood in this way, would be merely the generic ethics of work, efficiency, etc. Because of these considerations, we offer here a typological definition of profession. When we define profession according to prototype semantics, every characteristic which is included in the definition belongs to whatever the typical profession is. When each one of those characteristics is present in a cluster of occupational activities, we have what we can call a profession in its full sense, a prototypical profession. At the same time however, when one or another of those characteristics is missing or is only partially fulfilled, that alone is not a sufficient reason to cease calling these activities professions, even though they may be professions only in an incomplete sense. Since the characteristics themselves are susceptible to levels of achievement, it is possible to build scales of professionalisation. Not every profession is a profession to the same extent, nor does each one of them reach an equal level or degree of professionalisation at the same time. This kind of definition seems to fit in with the general trend towards the professionalisation of occupational activities. Accordingly, a cluster of occupational activities can be called a profession in its full sense only when all the following characteristics are present: 1) a stable dedication to such activities which fulfill some kind of specific social function; 2) for professionals these activities constitute their livelihood; 3) they are founded on specific theoretical knowledge and/or practical skills which non-professionals lack (experts vs. lay people); 4) the transmission of its knowledge and skills is institutionalised. Only those who acquire the theoretical knowledge and/or the practical skills in an institutionalised way following the established procedure can obtain the necessary accreditation to exercise the profession. Today universities have the important function of transmitting the knowledge which provides access to the practice of many professions. Likewise, the academic diploma is often a pre-requisite to be admitted to a professional practice. Moreover, some nonuniversity professions aim at eventually becoming part of the university curriculum. 5) the control of professional practice by professionals. With this aim, a professional association is created which, with public recognition, establishes the norms and procedures for gaining access to the profession, and the criteria for what good and bad professional practice is or should be. Membership in this association and an adherence to the norms established are necessary conditions for the practice of the profession.

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Professional Ethics or Deontology? In order to say what good professionals are like and how they ought to behave within their professional practices, it is useful to take into account both deontological norms and ethical references. When referring to the professions, ethics and deontology are two words which are often used interchangeably. Here, however, we want to emphasise the differences between them, distinguishing ethics from deontology without separating them radically. In so doing, we will try to underline the complementarity of the ethical and the deontological perspectives. Professional ethics focuses attention on the good: what it is good to do, what kind of good is served by each kind of profession, what kind of good lawyers, physicians, engineers, pharmacists or journalists, etc., are trying to promote. Professional deontology deals above all with duties and obligations (the Greek word deon means obligation), and tries to articulate a set of norms which every professional must observe. Deontology without ethics would lack a point of reference: the meaning of the norms, the reason why these norms exist and not others, what kind of good they are trying to promote or to protect would be unclear. Deontology demands actions or omissions; ethics, in addition to this, also proposes motives. Norms are certainly necessary. It is impossible to give a complete description or an exhaustive and totally precise enumeration of the characteristics of the good in general, or in particular. The good always has many aspects and not every aspect of the good can be expected from everyone. This is one of the reasons why norms are necessary; they try to establish the obligations that everyone must observe. Everybody must interpret these norms in the same way and they must apply to everybody with the same criteria. Without norms, neither the universality nor the equality of duties can be established. Without universality and equality in

necessary matters, social cooperation would establish and permit unequal and arbitrary practices. Deontology defines what every professional must do, while ethics deals with the numerous possibilities of doing good in the various professional practices. Ethics is ultimately a matter of conscience for the individual; deontology moves more in the realm of that which is approved by the professional authorities. It is common, of course, to appeal to the conscience of every professional to do his duty, but in many cases when people speak about the deontology of some profession, it is understood that with this word they are referring to the shared professional standards that are fixed by the professional association in a written text (the professional code).2 The Professionals and their Ethos: The Principle of Beneficence The good that can be achieved by the correct exercise of every professional practice provides the best criterion for judging who are good professionals based on their technical competence and their ethical attitudes. In any discussion about professional ethics in general, or about the specific ethics of a particular profession, it is first of all useful to ask about the ultimate aims behind the professional activities: what kind of good do they promote or are they trying to promote, what kind of service do they provide or try to provide? The purpose of medical practice is health care, helping someone who is ill get well, employing all the knowledge and technical means available at the time; or at least, that is how it is supposed to be. Judges, in their professional practice, try to promote justice when applying the law. The ultimate purpose of lawyers in their practice is to provide legal advice, defend and represent their clients in legal matters, before the courts and the administration, in contracts, etc. The division of labour in industrial and post-

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industrial societies has led to a situation in which there are many activities about which one can hardly say what their aims are or who they harm when they are done badly. Nevertheless, this is the very first point any approach to professional ethics should begin with: for whom and for what purpose is the practice of a specific profession? Sometimes, however, it is not easy to give a precise answer to that question, especially when speaking about concrete cases. But, in my view, this is the starting point for ethical reflection about the professions. In relation to ends and means, with the knowledge and the technical procedures which are available for the practice of a given profession, it is then possible to define a good professional, technically competent and ethically responsible. The basic principle that rules professional practices is the principle of beneficence: professionals should act for the benefit of their clients and never to their detriment3. Good professional practice is, first of all, one which provides good professional service, that is, the service that can be expected from a good professional. From this perspective, the client is the person whom the professional practice should benefit. Professions are practices or they are at least functional contributions to some kind of practices, in the sense that Alasdair MacIntyre gives to this word: cooperative activities which aim to produce or to promote the internal good, this means the good that can only be produced or obtained by doing such activities well. Practices are never random activities; they are cooperative and permanent since they try to achieve some good which is generally desired in any society. Therefore they need to be supported by institutions. When the practices become institutionalised, they need and at the same distribute external goods: e.g., money, power, prestige, status, and so forth. The institutionalisation of the professions also needs economic resources, requiring some kind of accumulation of power to a certain extent, and also distributes money, power,

prestige and status. Money, power, prestige and status are not devils; they are simply ambiguous. They only do harm when they overrule the internal good, thus perverting the professional practice. When that is the case, the needs, interests and desires of the clients are merely opportunities for the professionals to increase their earnings, their prestige and their power. Such an inversion is one of the main practical problem of professional ethics: i.e., corporatism. The professions at first appear on the social scene for the sake of some good which is best served by well-prepared experts. The permanent service of that good requires resources, money, power, etc., and with them comes the temptation to invert the relationship between the internal and external goods. In other words, deception allows one to achieve the external good without serving the internal one. But deceptive practices, even if undiscovered, corrupt the internal good of every professional practice. Research, health care, the legal and other practices are no longer what they pretend to be if they do not actually refer to the good at which they purport to aim. Our society is structured by the external good, whereas we have very different values concerning the internal good. We only share our concerns about the external good, how they should be distributed and so on, leaving aside the internal good. Clients and their Rights: The Principle of Autonomy The clients of professional services are not merely the object for whose benefit those services are carried out; they are persons and must be considered and treated as such. They have rights which need to be respected. They have decisive opinions about matters in which they are concerned as persons. By stating that professional activities are to be conducted for the benefit of the clients, the principle of beneficence obviously underscores a lack

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of symmetry between the benefactor and the beneficiary. Professionals know best what suits the persons who come to them seeking professional advice or help. This is why a person seeks professional services, and the professionals have to act in their clients best interests. But when professional practice tries to be guided only by the principle of beneficence, following it absolutely, it falls into a kind of paternalistic attitude. The professionals, like fathers, know better than their clients (sons and daughters) what their true needs and goals are. They will even protect them from their own ideas and ignorance, exhibiting a tendency to view the client or the user as a child. The clients obligation is to do as he is told because it is for his own good. Paternalism has often structured medical practice, and other professions can also be affected by such a mentality. The unequal relationship between professionals and their clients is essential: the latter need or are unaware of what the former can provide or know. Such superiority can be extended to the whole system of relationships so that the point of view of the clients no longer matters, and they become merely the objects of professional activities. In order to avoid paternalism in professional ethics, it is very important to pay attention to a second principle: the principle of autonomy. This principle comes from outside traditional professional ethics and articulates the moral, legal and political tradition of the Enlightenment which over the last two hundred years has become increasingly prevalent in the social and political mentality of the West. By taking the principle of autonomy into account, professionals are no longer the only ones who set the standards by which the professional practices are defined and organised. They are obliged to enter into a dialogue with their clients and to pay attention to their points of view, their rights and their preferences. They have to negotiate with them to reach an agreement about the professional services they can offer, and then the

clients may refuse or accept. Clients are usually adult persons (or are represented by others who can speak in their name) and have the right to say what their preferences are. Clients of professional services, even if they do not know many things that the professional knows, have rights, and are the principal party concerned with whatever happens to them. Professional services have to be offered as a contribution to the way of life of the clients. They are the ones who, once they are well-informed, ultimately have to decide whether to accept or refuse the services that professionals are offering them. Profession and Society: the Principle of Justice The principle of justice places professional practices under the criteria of social ethics. Social ethics opens a perspective from which the various needs and interests involved are coordinated with the available resources and possible courses of action. In this way, the tendency towards corporatism can be corrected. The professions, and even the professional ethos, are always in danger of constituting a separate realm, far removed from social needs. When professionals think only in internal professional terms, they constitute a totally autonomous world, ignoring what societys needs are or could be, as well as the scarcity of resources to finance their activities. Professionals, however, are not as autonomous as they pretend to be. Every profession only exists and can only be understood on the basis of the social function which it fulfills and which links the profession to the wider social context. Therefore, professional ethics must inquire about the role that a profession actually plays and whether that profession offers society what society needs or expects from it. It is also very important to take into account the situation in which the professional practice has to be carried out: e.g., scarcity of resources, cultural level of the population, how the needs are shaped, etc. Some

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ethical considerations may or may not be pertinent when, for example, certain professions have to be practised in a developed or developing country, in a democratic or non-democratic country, and so on. Many professions appeared originally as public services; all of them are an essential part of the common good of society. The most important problems challenging mankind today, such as inequalities between the North and the South, ecology, unemployment, violence, AIDS, new sources of energy, etc., cannot be solved when professionals do not do their work and fail to contribute to their solution. Professional practices are then to be judged according to standards of (national and international) social justice. Every profession has to ask itself, and try to answer, what its specific contribution to the common good should be. The political rulers of today have the responsibility of setting priorities and the distribution of the available resources according to standards of justice. In this context, it is necessary to mention that professionals have to assume their responsibilities in a context where corruption and confusion are present. Ethical reflection deals not only with ideal, but also with real situations. Dialogue Between Experts, Clients and Responsible Rulers Ethical decisions ought to be the outcome of a dialogue among experts, affected people (clients) and responsible rulers. In matters of professional ethics, in ethics committees, in public debates about such subjects, it is necessary to hear and to heed the voice of the experts, but also the voice of the clients and the voice of the responsible authorities. Any complex decision about how to act professionally must take into account the professionals point of view, since it is assumed that they are the competent agents in matters regarding their profession. What is known about law, medicine, architecture,

engineering, etc., is known respectively by lawyers, doctors, architects and engineers. Faced with a case where one of them does not know something, his or her professional colleagues are, in principle, the ones who can best judge his or her ignorance or incompetence. When the ethical approach in professional matters ignores the knowledge and skills of the professionals, it overlooks essential elements. The professional experts need to be taken into account in order to make the right decisions in matters of their competence. On the other hand, that does not mean that they would be the only ones who have to decide in these matters. When professional matters are only in the hands of the professionals, the theoretical approach and the practical exercise will be shaped by the ideology of professionalism (the surgery was perfect, but the patient is dead). We mentioned paternalism as one kind of monopoly of the experts in matters of their professions; corporatism is another. As a result, it is necessary to take account of the views and interests of the clients (affected people). By themselves, or through their relatives or representatives, they can and should articulate their point of view. This point of view deserves attention and has to influence professional practices. This does not mean that the clients have an expertise that the professionals lack, but that they are able to give an essential contribution to the process of decision-making, and this is why one must take their contribution into account. The clients are ultimately the beneficiaries and the main reason why professional services exist. But again, this should not be absolutised. Clients indeed have the problem and not the solution. They lack knowledge, skills and resources to get what they need or want. When the point of view of the clients is overwhelming, or even the only one that counts, the ends may be very clear but the means of reaching them are not available. It is then very easy to fall into a sterile moralism or sentimentalism. As we have seen above, experts and their

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clients do not meet in an extra-social space, nor in a paradise of unlimited possibilities and resources. There should be a way of joining the various needs and interests with the available possibilities and resources according to standards of justice. That is the specific task of political rulers in society at large, and of managers within institutions and organisations. Of course, they have to ask advice of experts and take account of the needs and interests of clients (affected people), and insofar as it is impossible to satisfy all the requests involved, they must decide which needs and which ends are more and less important, and which can or cannot be satisfied with the available resources in a given situation. This should occur according to the criteria of justice. When there are not enough resources for every demand, a reasonable distribution must be decided among the needs and demands. The articulation of such a dialogue among experts, people affected and responsible rulers is a very difficult task, even more so in our society where everyone inhabits ones own world and usually speaks only with people who share the same opinions. A kind of Pentecost is needed, so that everybody speaks his own different language and everybody understands what the others are saying. The university could be a very good institutional space for hearing and understanding these different languages of experts, their clients, and the rulers. Personal Identity and Professional Vocation One final word about what the profession means for the one involved in it. Work can be considered as a job, as a career, or as a calling. For people with a job, what matters is the money they receive as a salary in exchange for the service or products that they provide. Taken as a career, work is a source of increasing status, power and

social esteem. For those whose work is a calling, work is inseparable from life. They live for the work they do. It is quite rare today to speak about professional work as a calling. It may be helpful to recall that profession as well as calling are words with a religious background. Today it is a commonplace to mention that, according to Max Weber, Luther was the first to apply the German word Beruf (profession, occupation) to worldly activities. The vocation (Berufung) of all Christians is not to become a monk, but to exercise the worldly occupations that they are called upon to perform. Profession in its early sense was not far from this meaning: to profess a religious life in a monastery became applied to the worldly activities of physicians, judges, military officers, etc. Professionals experienced their professions as a calling to which their life was consecrated. R. Bellah and the other authors of Habits of the Heart write that the idea of calling today is more and more difficult to understand in our society. That has consequences for professional ethics when, as they write, the lack of vocation implies a lack of moral sense4. I would not want to suggest that the interpretation of professions in terms of vocation could be the key to the ethics of the professions. My point in this seventh thesis is a different one: work, and especially professional work, makes an important contribution to the self. Nobody can say who he or she is without also saying what kind of work he or she does, for what profession his or her life is lived. Professions are callings when the professional has an important personal stake in their professional work. It is of course possible to be more inwardly directed (calling) or more outwardly directed (job, career). Max Weber distinguished between living from politics and living for politics. Both can be applied to the professions.

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Notes
1. In sociological terminology, a profession is a cluster of occupational roles, that is roles in which the incumbents perform certain functions valued in the society in general, and by these activities, typically earn a living at a fulltime job. T. PARSONS, Essays in Sociological Theory. London, The Free Press of Glencoe, 1954, p. 372. 2. Every profession needs to be appreciated by the public and to have a good public image and social recognition, both of its technical competence and its ethical standards. Deontological norms contribute to this recognition and therefore to the good of the profession. But sometimes deontological codices are so formulated as to protect and promote the interests of the professionals rather than assuring clients of good professional service. The basic axiom of corporatism is: what is good for the profession is good for its clients. 3. Above the principle of beneficence is the principle of non-maleficence (primum non nocere). In this rethinking of the main points of professional ethics, I am not paying any special attention to this principle because it works with the same standards in a negative way. Often it is not so clear what the good may be in a given situation, but it is very clear what the harms are. Cf. D. GRACIA, Principios de biotica. Eudema, Madrid, 1989; and D. GRACIA, Primum non nocere. El principio de no malefecencia como fundamento de la tica mdica. Madrid, Royal Academy of Medicine, 1990. 4. R. BELLAH, et al., Habits of the Heart. Berkeley, University of California Press, 1985, p. 66.

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