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News Bulletin : ADA News Bulletin November 2010
38 NOVEMBER 2010 By these criteria, craft and trade guilds and their modern-day counterparts do not fit into the professional mode, for they were and are commercial and profit-motivated. Unlike a profession, they are not by definition altruistic or ethical. Trade unions protect the interests of their members; professional associations protect the interests of their members but have an even stronger mandate, in effect a duty, to protect the interests of those they serve and of society itself. Note the emphasis on ethics in the definition of a profession adopted at the Annual General Meeting, 26 May 1997, of Professions Australia: A profession is a disciplined group of individuals who adhere to ethical standards and hold themselves out as, and are accepted by the public as possessing special knowledge and skills in a widely recognised body of learning derived from research, education and training at a high level, and who are prepared to apply this knowledge and exercise these skills in the interest of others. It is inherent in the definition of a profession that a code of ethics governs the activities of each profession. Such codes require behaviour and practice beyond the personal moral obligations of an individual. They define and demand high standards of behaviour in respect to the services provided to the public and in dealing with professional colleagues. Further, these codes are enforced by the profession and are acknowledged and accepted by the community (Professions Australia, 1997). In Professionalism, the Third Logic, Eliot Freidson defines professionalism as follows: "Professionalism may be said to exist when an organized occupation gains the power to determine who is qualified to perform a defined set of tasks, to prevent all others from performing that work, and to control the criteria by which to evaluate performance" (Freidson, 2001, p. 12). This definition is broad enough to include the trades protected by guilds in the Middle Ages. However, Freidson goes on to say that ethics is the very soul of professionalism. Professionalism is not only a skills set in a given occupation; it is an ineffable something that the person exudes in manner, dress, speech and standards of practice that is palpably powerful: standards like honesty, due diligence, perseverance, willingness to listen and learn, creative thinking within a framework of training, and other qualities most people would be hard put to describe but which they expect in the professionals with whom they engage. Another word for these standards is 'virtues' and the hard-to describe something exuded is 'trustworthiness': the sum total of these virtues. The doctor is trusted to have a patient's best interests in mind -- an expectation prevails that he or she will do no harm and is sufficiently expert at least to do some good. The degree displayed on the wall certifies this, but so do the intangibles gleaned, depending on the community's culture, from the white coat, the clean fingernails, and the manner and the choice of words. Through these, the professional conveys intangible standards that win our trust that he or she is there to serve interests larger than him- or herself. Wrapped up in our expectations of the professional -- whether doctor, lawyer, pastor or other -- is that he or she has our best interests at heart. Our medical records, our confessions of wrongdoing, the compromising and even incriminating information that may harm our wellbeing or degrade our reputation -- these are safeguarded by a professional ethic of client/professional confidentiality. We can reveal ourselves in our deepest vulnerabilities -- our diseases, our nakedness, our business secrets, our spiritual dysfunction -- and be treated in such a way as to promote our welfare. It is also expected that the professional will hold in trust the best interest of society. If the lawyer knows that a client is likely to kill someone, he or she is released from solicitor-client privilege in the interest of protecting society. Dentists are expected to release our records if these will aid in identifying our bodies. People understand (although they might not comply) when the pastor enjoins them to report their childhood molester to the police. It is generally accepted that a contagious dangerous disease may result in the doctor placing the patient in quarantine, or at least reporting the infection to health authorities in the interest of society. There are personal and public expectations of the professional based on the notion that a professional is motivated by something other than raw gain. This is even an expectation of business professionals, whose explicit raison d'être is to make a profit. When a company promotes its paper as being made from recycled material or declares that no animal testing was done on its products, the public is reassured. The public is also reassured when a corporation's CEO contributes to charity; it is, however, less reassured when he or she flaunts wealth in ways reminiscent of a Roman bacchanalian banquet. Professionals, because they are professionals, are expected to have some sense of the larger picture of life -- some sense of responsibility to the whole of society and humanity. Professionals express their altruism through serving in networks of responsibility within their profession, often on a volunteer basis. A certain degree of altruism is expected in the true professional, a certain amount of selfless service. I have my grandfather's Bible from the time he went to what is now Malawi in central Africa in the 1890s to serve as a medical doctor in the Free Church of Scotland mission. Travelling south because he had contracted malaria, he found himself in the middle of the Anglo-Boer war. He settled in the Afrikaner republic of the Orange Free State, where he set up practice on the banks of the water supply dam of the town of Potchefstroom. There he worked out of a tent for the rest of his life, doctoring the local community. He would not accept fees, and the local people provided for him and his family. My grandmother was ultimately supported by the medical association provident fund because my grandfather earned no money his entire life. That was a true vocation -- an example of extreme altruism. However, wishing to profit from one's labour and still serve one's clients optimally is not necessarily incompatible. Marc T. Law and Sukkoo Kim note that during the Progressive Era in the United States of America, when advances in knowledge and specialization led to the adoption of occupational licensing, members of a particular profession approached the state governor to lobby for legislation that would license their profession. As each occupation was becoming more complex and specialized, it was becoming ever harder to guarantee quality of professional service. In their petitions, the professionals urged that incompetents and charlatans be eliminated by licensure so that the people would be better served and protected from unsafe practices. When questioned whether the professionals were truly concerned with advancing the people's health and safety or whether they were more interested in monopolizing their field and eliminating competition that would keep prices low, the professionals' spokesman admitted honestly "a little of each" (Law & Kim, 2005). There is nothing inherently wrong with professionals' wanting 'a little of each' of both altruism and profit. Professionalism only loses its calling when profit trumps altruism. However, a case can be made that altruism and service tend to generate profit, prosperity and plenty. The two are far from incompatible. This argument is not developed further here and will be the subject of a later paper.
ADA News Bulletin October 2010
ADA News Bulletin December 2010