Kenneth D. Pimple, Ph.D., is Associate Scholar at Indiana University-Bloomington.
Following the 40th anniversary of the Poynter Center for the Study of Ethics and American Institutions at Indiana University-Bloomington (IUB) in 2012, and looking forward to the 25th annual meeting of the Association for Practical and Professional Ethics (APPE) in 2016, these two closely related organizations decided to consider the future of professional and practical ethics. The then-director David H. Smith of the Poynter Center led the effort to create APPE in 1991 and the former has hosted the latter ever since. [1]
APPE’s “Year of Conversation on the Future of Practical and Professional Ethics” was formally announced in 2015; we know of thirteen events across the U.S. and one in Japan. The largest single U.S. effort was held at IUB, where I organized six workshops between September 25, 2015 and June 9, 2016 – one workshop every 1⅔ month on average. [2] All of the keynote speakers were eloquent, wise, informative, and challenging, and discussion was lively.
Professionalism
The original professions – the ministry, medicine, and law – were well established as significantly different from other occupations at least by 1711 CE. [3] All three required a greater-than-usual amount of special education and all had a clear normative purpose that more-or-less defined their respective ethical obligations and transgressions.
In the second half of the twentieth century, professions in the United States and other developed countries faced a decline in reputation in the face of prominent scandals in the original professions, as well as in a number of institutions, including business, journalism, government, engineering, and science that had also claimed the status of profession. External and internal scrutiny into the practices and principles that are meant to guide professionals were accompanied by widespread efforts to update or create codes of ethics, the development of formal programs of ethics instruction in pre-professional training, and a stronger emphasis on continuing education in many professions. [4]
At that time, the discourse of professional ethics emphasized dilemma ethics, which focused on the individual who found himself in an ethical bind, such as being ordered by a superior to falsify information. Later, preventive ethics brought attention to institutional changes intended to promote ethical behavior and discourage unethical and illegal behavior. Recently, Deborah Johnson articulated the concept of anticipatory ethics [5], which holds that the ethical ramifications of new technologies should be examined and considered as they are developed to maximize the good and minimize the bad.
Today we find that much of the existing work on professionalism and professional ethics has fallen behind emerging conditions that affect how young professionals see themselves, their relationship to employers, each other, and the ethical decisions they face, as well as their views about education, work, family, and work-life balance.
These conditions include changes in the workforce, such as changes in hiring, retention, and collaboration, and increasingly diverse, and often enervated, workers; the rise of freelance professionalism and personal branding; cultural and social changes, including shifting notions of the public and private and the impact of big data on standards, privacy, and confidentiality; the expanding roles of regulatory and administrative bodies in various sectors, including the surveillance regime born of international terrorism; and the impact of high debt, post-recession housing patterns, and healthcare inflation.
[Due to space constraints, I will draw explicitly only from the first three IUB workshops.]
Developing and Defending Your Ethical Professional Brand
Trish Tchume, nonprofit advocate and recently inaugural Executive Director of the Young Nonprofit Professionals Network, January 2016. non-profit organizations
Dedicated nonprofit workers are people who want to do good, not just for individuals, but also for communities and the common good. But dedication can be weakened under the pressures of inadequate funding, leading to competition for access to local donors (which is like stealing from your own siblings); chronically low salaries, beating workers down; and for-profit envy, enticing the ranks to emulate corporate practices and twisting values and commitments.
Ethical guidance can be found across a spectrum from the most private to the most public – your feelings and intuitions; your workplace culture and your role in it; your community and its standards; and the story you want to tell. Each of these four sources of moral strength support the others and inform decisions in the quiet of one’s heart as well as the echoes of the mountaintops. The also apply to all professionals, and perhaps to all humans.
Committed Professionals: Handling Obstacles to Ethics in Public Health
Lisa M. Lee, Executive Director, Presidential Commission for the Study of Bioethical Issues, November 2015. public health
The tension between the one and the many is illustrated by the differences between bioethics and the ethics of public health. Early in her talk, Dr. Lee told us that Arnold S. Relman opined in 1980 that medicine had become an expansive for-profit enterprise that
creates the problems of overuse and fragmentation of services, overemphasis on technology, … and it may exercise undue influence on national health policy. … Closer attention from the public and the profession, and careful study, are necessary to ensure that the “medical-industrial complex” puts the interests of the public before those of its stockholders. [6]
Public health emphatically “puts the interests of the public” before any stockholders. It is often invisible, underfunded, and overtaxed – even while public health is more cost-effective than medicine. [7] A 2013 report concluded that “Preventing disease and injury is the most cost-effective, common-sense way to improve health; despite this fact, for every dollar spent on health care in the United States today, only about four cents goes towards public health and prevention.” [8]
Like nonprofit workers, public health professions are dedicated to do good. Unfortunately, only half of accredited U.S. Schools of Public Health require any ethics training. Public health professionals are committed to ethics and appreciate the ethical issues involved in, for example, acquisition and prioritization of scarce resources and collection and use of data. However, many public health professionals do not see the need for ethics training, often because, in their words, they “believe in social justice” and trust their “moral compass.”
Dr. Lee argued that three non-intuitive ethical values should be included in public health training: Transparency – giving reasons for policies and actions; pluralism – serving a disparate public; and community focus – shifting moral governance from the individual to the collective.
Professions and Service to All: Challenges, Problems, and Solutions
Steve Salbu, Cecil B. Day Chairholder and Professor, Scheller College of Business, Georgia Institute of Technology, September 2015. higher education, law, medicine / health care
Liberal education has long been considered an intrinsic and public good, as it shaped responsible, reflective, and knowledgeable democratic citizens. As such, state support of higher education was also considered a public good. However, the 21st century’s wide adoption of practices and values endemic in the commercial world transformed a college education into a commodity, purchased for personal use and benefit, primarily access to a good salary. As a private good, higher education should not be subsidized by the state.
One result of this shift has been monstrous tuition debt, which is harmful not only to graduates and their families, but also society in general. The cost of a degree in law or medicine (among other professions) is so high that young lawyers and doctors can only survive by taking jobs or practices with large salaries. Pro bono services diminish and underprivileged areas have little access to law and health services. In such an atmosphere, few graduates have the luxury of dedicating any of their time for the public good.
Conclusion
The insights and arguments of these three scholars, which I have presented in reverse chronological order, in their own ways explore and present professional ethics in a more expansive and humane light than I am used to seeing. In particular, they seem variously to feature three threads.
Formation – Teaching about ethics, including professional ethics, is easy compared to inculcating a determination to value ethics and live a moral life. The latter is a life-long project that we, as ethicists and teachers, can barely touch. Without preformation [9] – that is, early childhood experiences and the often tacit tutelage of parents, siblings, friends, teachers, and others – professional formation would be impossible. Those of us who educate professionals should be thankful to these earlier teachers for the relative ease of our work.
The common good – The social aspects of practical and professional ethics are fundamental. We must talk about and understand the nuances of ethical behavior, but the more complex and communal work of nurturing the common good and social justice is deeply challenging.
Consumer capitalism – The world of buying and selling is vital, but in the United States the culture of consumerism is becoming our model for too many aspects of our public and private lives. The influence of the value systems of commodification and instrumentalism threaten to undermine other, more lofty, value systems. We should remember that we are humans first and scholars/non-profit workers/public health professions/ doctors/lawyers second. We may spend most of our time on our particular projects, but we should always be aware of the larger picture and the obligations that fall upon us to make it a better picture.
Professional ethics is usually studied and discussed one profession at a time. If nothing else, APPE’s “Year of Conversation on the Future of Practical and Professional Ethics” showed that no profession is an island.
References
[1] This happy and productive informal working relationship ended on June 30, 2016, when IUB dissolved the Poynter Center. APPE has found a temporary home.
[2] Parts of this paper are adapted from the blog for the IUB project at http://fpe.indiana.edu. I am indebted to Emma Young, who wrote about as much of the blog as I did.
[3] From the Oxford English Dictionary, definition of “Profession” 7.a: An occupation in which a professed knowledge of some subject, field, or science is applied …"1711 J. Addison Spectator No. 21. ¶1 The three great Professions of Divinity, Law, and Physick, at http://www.oed.com/view/Entry/152053; verified 02/15/2016.
[4] I’ve learned much about professional ethics by osmosis. Corrections are welcome.
[5] Johnson, Deborah G. 2010. “The role of ethics in science and engineering.” Trends in Biotechnology 28(12):589-590, and 2011. “Software agents, anticipatory ethics, and accountability.” In The growing gap between emerging technologies and legal-ethical oversight: The pacing problem, ed. Gary E. Marchant, Braden R. Allenby, and Joseph R. Herkert, 61-76. Dordrect/New York: Springer.
[6] Relman, Arnold S. 1980. “The New Medical-Industrial Complex.” New England Journal of Medicine 303(17):963-970 (October 23).
[7] Lee mentioned the cost-effectiveness of public health, but I did not find a statistic in our notes. I found another source [8]; if the quotation is off the mark, the fault is mine.
[8] “Return on Investments in Public Health: Saving Lives and Money,” Robert Wood Johnson Foundation, December 2013, at http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf72446; verified Feb 02 2016.
[9] I recently learned the word “preformation” from a colleague who attributed the word to the late Tony Pizzo MD, a moral exemplar and mentor to many in Bloomington.