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Published online by Cambridge University Press: 09 September 2014
The purpose of this article is to study critically the positions of six authors on the foundations of the professions and of professional ethics. These positions are placed along a continuum which is created by correlating two variables that appear in each author's writings. The implied or explicit anthropology and metaethical theory of the authors are central concerns of the study. The issue whether the professional is governed by role-specific duties or by role-distinctive duties is analyzed in depth. In the end, the author cannot accept any of the six positions and so the final section of the article fashions a constructive proposal grounded in a social metaphysics of the human person.
1 For example, see Durkheim, Emile, Professional Ethics and Civic Morals, tr. Brookfield, Cornelia (Westport, CT: Greenwood, 1983);Google ScholarLarson, Magali S., The Rise of Professionalism: A Sociological Analysis (Berkeley: University of California Press, 1977);Google ScholarMoore, Wilbert E., The Professions: Roles and Rules (New York: Russell Sage Foundation, 1970);Google Scholar the entire issue of Daedalus 92(Fall 1963); and Parsons, Talcott, “Professions,” International Encyclopedia of the Social Sciences 12 (New York: Collier & Macmillan, 1968), 536–47.Google Scholar
2 For two philosophers who have recently written in this area, see Bayles, Michael D., Professional Ethics (Belmont, CA: Wadsworth, 1981)Google Scholar and Goldman, Alan H., The Moral Foundations of Professional Ethics (Totowa, NJ: Rowman and Littlefield, 1980).Google Scholar For two volumes by Christian ethicists, see Reeck, Darrell, Ethics for the Professions: A Christian Perspective (Minneapolis: Augsburg, 1982)Google Scholar and Campbell, Dennis M., Doctors, Lawyers, Ministers: Christian Ethics in Professional Practice (Nashville: Abingdon, 1982).Google Scholar
3 For my article where I originally defined and applied the “specificity-distinctiveness” terms to the field of Christian ethics, see “Christian Ethics: Distinctive and Specific?” in Curran, Charles E. and McCormick, Richard A., eds., Readings in Moral Theology No. 2: The Distinctiveness of Christian Ethics (New York: Paulist, 1980), pp. 90–110.Google Scholar
4 With regard to the possible limits on the psychologist's duty of confidentiality, I am thinking of the famous Tarasoff v. Regents of the University of California case (July 1, 1976). For a review of this case and a summary of the legal opinions which were handed down, see Beauchamp, Tom L. and Childress, James F., Principles of Biomedical Ethics (2nd ed.; New York: Oxford, 1983), pp. 281–84.Google Scholar On the other hand, the priest's duty to keep confessional secrecy may be exceptionless, but I would argue that the duty can be justified by common methods of moral justification and also comprehensible (although not applicable) to laypeople.
5 See Edelstein, Ludwig, “The Professional Ethics of the Greek Physician” in Reiser, Stanley J., Dyck, Arthur J., and Curran, William J., eds., Ethics in Medicine: Historical Perspectives and Contemporary Concerns (Cambridge, MA: MIT Press, 1977), p. 41.Google Scholar
6 See Berlant, Jeffrey L., “Medical Ethics and Monopolization” in Reiser, , pp. 56–57.Google Scholar
7 Ibid., pp. 59-64.
8 Edelstein, Ludwig, Ancient Medicine (Baltimore: Johns Hopkins University Press, 1967).Google Scholar
9 See May, William F., “Code, Covenant, Contract, or Philanthropy,” The Hastings Center Report 5 (December 1975), 31.CrossRefGoogle ScholarPubMed
10 See Berlant in Reiser, p. 56.
11 American Medical Association's Code of Medical Ethics (1847) in Reiser, , p. 26.Google Scholar
12 Ibid., p. 28.
13 Ibid., p. 34. For the AMA these benefits entail a set of obligation? which society owes to the medical profession, e.g., “physicians are justly entitled to the utmost consideration and respect from the community” (p. 34).
14 See Edelstein in Reiser, pp. 43 and 49, n. 21.
15 AMA Code of Medical Ethics (1847) in Reiser, , p. 26.Google Scholar
16 See Edelstein in Reiser, pp. 40-51.
17 American Bar Association's Code of Professional Responsibility (1970) in Black's Law Dictionary (St. Paul, MN: West, 1970), p. xvii.Google Scholar Emphasis mine. This phrase is deleted in the revised (1983) ABA's Model Rules of Professional Conduct.
18 For a brief review of metaethics and the various forms of relativism, see Veatch, Robert M., “Does Ethics Have An Empirical Basis?,” The Hastings Center Studies 1 (1973), 50–65.CrossRefGoogle ScholarPubMed
19 This is not entirely unfair to Drucker because in his book on management, where he discusses the professions in general, he holds to views similar to those in this section. See Drucker, Peter F., Management: Tasks, Responsibilities and Practices (New York: Harper & Row, 1974), esp. pp. 366–75.Google Scholar
20 Drucker, Peter F., “What Is Business Ethics?,” The Public Interest 63(Spring 1981), 18–19.Google Scholar
21 Drucker, , Management, p. 366.Google Scholar
22 Drucker, , “What Is Business Ethics?,” p. 19.Google Scholar Emphasis Drucker's. It is at least questionable that Kierkegaard meant his ethics to apply universally. It is more likely that Kierkegaard developed two moralities which conflicted, i.e., one for the “knight of faith” and one for others. See Kierkegaard's, Fear and Trembling (New York: Doubleday, 1955).Google Scholar
23 Ibid., pp. 22-29.
24 Ibid., pp. 29-34.
25 Ibid., p. 32.
26 Ibid., pp. 35-36.
27 Ibid., p. 35.
28 Freedman, Benjamin, “A Meta-Ethics for Professional Morality,” Ethics: An International Journal of Social, Political and Legal Philosophy 89 (October 1978), 1.CrossRefGoogle ScholarPubMed
29 Ibid., p. 17.
30 Ibid., p. 10.
31 Freedman, Benjamin, “What Really Makes Professional Morality Different: Response to Martin,” Ethics: An International Journal of Social, Political and Legal Philosophy 91 (July 1981), 628–29.CrossRefGoogle Scholar
32 Freedman, , “A Meta-Ethics,” p. 14.Google Scholar
33 Ibid., p. 4.
34 Freedman, , “What Really Makes,” p. 628. Emphasis mine.Google Scholar
35 Ibid.
36 Ibid.
37 Ramsey, Paul, The Patient as Person: Explorations in Medical Ethics (New Haven: Yale University Press, 1974), esp. pp. xii–xiii.Google Scholar
38 May, William F., “Professional Ethics: Setting, Terrain, and Teacher” in Callahan, Daniel and Bok, Sissela, eds., Ethics Teaching in Higher Education (New York: Plenum, 1980), p. 211.Google Scholar
39 May, William F., The Physician's Covenant: Images of the Healer in Medical Ethics (Philadelphia, Westminster, 1983), pp. 13–20.Google Scholar
40 May, , “Code, Covenant, Contract,” p. 31.Google Scholar
41 Ibid., pp. 33-34.
42 See esp. May, , Physician's Covenant, pp. 125–26;Google Scholar and “Code, Covenant, Contract,” p. 31.
43 Ibid.
44 May, Physician's Covenant, p. 108.
45 I think it is fair to say that May's notion of covenant is less indebted to Karl Barth and Paul Ramsey than it is to H. R. Niebuhr. See Niebuhr, H. Richard, The Responsible Self: An Essay in Christian Moral Philosophy (New York: Harper & Row, 1963).Google Scholar Niebuhr's ethics are probably more an “ethics of response” than an “ethics of responsibility,” and they, like May's, lack a metaphysics of the person.
46 May's original essay was published in The Hastings Center Report as “Code, Covenant, Contract, or Philanthropy.” See note 9 above.
47 See May, “Code and Covenant or Philanthropy and Contract?” in Reiser, pp. 69-70; and Physician's Covenant, pp. 108, 111, 119-20. In one place May describes the “ontological change” of the professional in the following way: “A professional eats to heal, drives to heal, reads to heal, comforts to heal, rebukes to heal, and rests to heal. The transformation is radical, and total. The Hippocratic Oath, under this ontological aspect, can be summarized: aut medicus aut nihil; from this moment, I am a healer or I am (literally) nothing” (“Code and Covenant?,” p. 73).
48 See ibid., p. 69; and Physician's Covenant, p. 108.
49 May, “Code and Covenant?,” p. 70.
50 Veatch, Robert M., A Theory of Medical Ethics (New York: Basic Books, 1981), pp. 147–59.Google Scholar
51 Veatch, Robert M., “The Case for Contract in Medical Ethics” in Shelp, Earl E., ed., The Clinical Encounter: The Moral Fabric of the Patient-Physician Relationship (Boston: D. Reidel, 1983), pp. 105 and 109–11.Google Scholar
52 Veatch, , A Theory of Medical Ethics, p. 120.Google Scholar
53 Ibid., p. 138.
54 See Veatch, Robert M., Value-Freedom in Science and Technology: A Study of the Importance of the Religious, Ethical, and Other Socio-Cultural Factors in Selected Medical Decisions Regarding Birth Control (Missoula, MT: Scholars Press, 1976), pp. 148–49;Google ScholarA Theory of Medical Ethics, p. 123; and “The Case for Contract in Medical Ethics,” p. 110.
55 Veatch, , A Theory of Medical Ethics, pp. 125–26.Google Scholar
56 See May, Physician's Covenant, p. 126.
57 Veatch, , A Theory of Medical Ethics, p. 124.Google Scholar
58 Veatch, , “The Case for Contract in Medical Ethics,” p. 194.Google Scholar
59 See Veatch, , A Theory of Medical Ethics, p. 129;Google Scholar and “The Case for Contract in Medical Ethics,” p. 194.
60 See Veatch, , A Theory of Medical Ethics, pp. 135–37;Google Scholar and “The Case for Contract in Medical Ethics,” pp. 194-95.
61 Veatch, , A Theory of Medical Ethics, p. 83.Google Scholar
62 Veatch, Robert M., “Medical Ethics: Professional or Universal?,” Harvard Theological Review 65 (1972), 559.CrossRefGoogle Scholar
63 Veatch, , A Theory of Medical Ethics, pp. 82–88.Google Scholar
64 Ibid., pp. 126-27 and 130-31.
65 Ibid., p. 127.
66 Camenisch, Paul F., Grounding Professional Ethics in a Pluralist Society (New York: Haven, 1983).Google Scholar
67 Ibid., p. 2.
68 Ibid., p. 9. For a similar view, see Page, B. B., “Who Owns the Professions?,” The Hastings Center Report 5 (October 1975), 7–8.CrossRefGoogle ScholarPubMed
69 Ibid., pp. 53-54. An historical note might be helpful at this point. Cicero in the first century B.C.E., following Panaetius who was the founder of middle Stoicism, distinguished the crafts from what we today call the traditional professions by ascribing a moral duty (officium) to the “professions.” In the First Book of his De Officiis, where the moral good (bonum honestum) is discussed, Cicero claimed that, along with the “profession” of being a judge, medicine (medicina) and teaching (doctrina rerum honestarum) are morally worthy (honestae) “professions” (Ch. 42). Cicero's implication is that these “professions” have moral obligations (officia) attached to them. It is unclear, however, whether Cicero would have agreed with Camenisch (or Veatch) that these duties are dependent on and subordinate to the larger moral entity of society.
70 Ibid., pp. 34-35.
71 Ibid., pp. 58 and 103.
72 Ibid., pp. 91-94.
73 MacIntyre, Alasdair, After Virtue: A Study in Moral Theory (Notre Dame, IN: University of Notre Dame Press, 1981).Google Scholar
74 Camenisch, , Grounding Professional Ethics, p. 93.Google Scholar
75 Ibid., p. 91.
76 Ibid., p. 12.
77 Ibid., p. 59.
78 For example, see Keane, Mark, “A Post-Watergate Code of Ethics,” Public Management 57 (1975), 7–12;Google Scholar and Clement, Douglass, “Nestle's Latest Killing in the Bottle-Baby Market,” Business and Society Review 27 (Summer 1978), 60–64.Google Scholar
79 Camenisch, , Grounding Professional Ethics, p. 148, n. 2.Google Scholar
80 Although Freedman begins with society's needs, it might be recalled that his position allows for the professions to part ways with society by their adoption of a different (“deviant”) moral world.
81 Berlant argues that the AMA began using the ideology of the “ideal of service to humanity” in its 1912 Code of Ethics, and the reasons for starting its use were political and economic in nature. See Berlant in Reiser, p. 63.
82 Several Christian ethicists have recently discussed the primary focus of the professions under the rubric of “enablement.” See Reeck, , Ethics for the Professions, esp. pp. 38–39;Google Scholar and Rammer, Charles L. III, , “Vocation and the Professions” in Ogletree, Thomas W., ed., The Annual of the Society of Christian Ethics (Waterloo, Ontario: Council on the Study of Religion, 1981), 153-83, esp. 176–78.Google Scholar
83 For a more in-depth discussion of my position which could be applied here also, see “The Dependence of Christian Morality on Faith: A Critical Assessment,” Eglise et Théologie 12 (Winter 1981), 237–77;Google Scholar and “The Relation Between Faith and Morality: Sources for Christian Ethics,” Horizons 9 (Fall 1982), 251–70.CrossRefGoogle Scholar