For a few reasons, I’ve been thinking a bit over the last few months about professionalism and professional codes. In fact, that’s the topic that’s attracted most of my attention here since… oooh, ages ago. I find the idea of a code of professional ethics troubling in many ways, but also fascinating. And one of the fascinating questions has to do with what they’re for.
They can’t be meant as a particularly useful tool for solving deep moral dilemmas: they’re much too blunt for that, often presuppose too much, and tend to bend to suit the law. To think that because the relevant professional code enjoins x it follows that x is permissible or right smacks of a simple appeal to authority, and this flies in the face of what it is to be a moral agent in the first place. But what a professional code of ethics may do is to provide a certain kind of Bolamesque legal defence: if your having done φ attracts a claim that it’s negligent or unreasonable or something like that, being able to point out that your professional body endorses φ-ing will help you out. But professional ethics, and what counts as professional discipline, stretches way beyond that. For example, instances of workplace bullying can be matters of great professional and ethical import, but it’s not at all obvious that the law should be involved.
There’s a range of reasons why someone’s behaviour might be of professional ethical concern. Perhaps the most obvious is a concern for public protection. If someone has been found to have behaved in a way that endangers third parties, then the profession may well want to intervene. For example: if an HCP knew herself to be a carrier of a transmissible disease but did nothing about it, this would quite plausibly be a matter for professional concern, irrespective of what the law says, or whether anyone had been harmed. The same would apply if we discovered that a surgeon was unable to function without a large brandy to settle his nerves. But we’d want to make sure that the professional concern was for the right thing. It would be inappropriate to sanction someone merely for being a carrier, or for being alcohol dependent. (Along these lines, it seems defensible to me not to have suspended Martin Royle, a surgeon who falsified prescriptions in order to satisfy his addiction to painkillers. It’s better to treat an addiction than to punish it.)
A second reason is for the sake of collegiality. For example, there’s nothing illegal about being a racist, and there probably shouldn’t be; but it is at the very best distasteful. Imagine you discover that your colleague is an abiding racist. It is not hard to see how this knowledge might have implications for your professional interactions – especially (but not only) if you’re a member of one of the groups to which your colleague has a demeaning attitude. (Indeed, the same might be true if he had used to be a racist, but had changed his attitudes. I suspect that that’s the sort of thing that might have a fairly long half-life.) Now imagine that your colleague is a frequent attendee at rallies, held in support of racist policies, that are often associated with threatening behaviour: he doesn’t just dislike some people, but is visibly hostile to them. That, it seems to me, might be a matter of professional concern, because it will predictably make the working environment much more difficult. It would be harder to trust this colleague (again, especially but not only if you happen to be a member of one of the groups he hates). That might be sufficient to raise worries about whether he’s a fit person to do the job in question. Again, though, there’d have to be a proviso: there is a difference between one’s professional abilities and one’s personal attitudes, and between how one behaves in and out of work. A surgeon is a surgeon for all that. So there is a genuine problem here concerning what to do. But a genuine problem means that there is a cause for concern.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.