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News Bulletin : ADA News Bulletin December 2010
35 DECEMBER 2010 If they are not open to assimilating the new knowledge gained by interface with society, professions may stifle truth and, in so doing, become a detriment to society. A current example might be the furor, in the global-warming debate, over the exclusion from the halls of power of dissenting voices and the journals that publish them. The current outrage stems from the exposing of email correspondence between professional scientists, which included exhortations to exert peer pressure on dissenting colleagues in order to have them conform to one view. An earlier example -- dating from the mid-nineteenth century -- is found in the story of Ignaz Semmelweiss, an assistant physician in the maternity wards of the Vienna General Hospital. Semmelweiss observed that women in the first section of the maternity ward contracted and died of puerperal (childbed) fever at much lower rates than women in the second section of the ward. Women in the first section were attended to by nurse-midwives, whereas women in the second (more deadly) section were attended to by medical students, some of whom had just come from dissecting cadavers in the adjacent morgue. Semmelweiss' suspicions were confirmed when a hospital pathologist died of a fever with puerperal-like symptoms after cutting a finger on an unwashed autopsy instrument. Semmelweiss was sure that "cadaverous particles" were at fault. The medical students were bringing these particles into the maternity ward from their dissections. Semmelweiss reduced deaths and infections in the second section of the maternity ward dramatically when he instructed medical students to wash their hands in a chlorinated solution before handling mothers and their newborns. Semmelweiss' germ theory was not well received by the medical establishment. The political, social and economic powers of Vienna of the day united against Semmelweiss, discrediting him and isolating him until he ended his days in the asylum to which he was committed (Carter & Carter, 1994). The protection of the profession's viewpoint mattered more than ethical treatment of a dissenting messenger and more than the public interest. When this happens, a profession will lose its power, prestige and, ultimately, its profits if its faulty outlook is not corrected. In 1992, Lord Benson proclaimed that a profession, in order to be considered professional, must operate within certain ethical principles, most of which ultimately pertain to the public interest. In fact, he said that ethical standards in a profession "should be higher than those established by the general law" and "designed for the benefit of the public and not for the private advantage of the members" (Spada Limited, 2008, p. 38). State protection makes it incumbent upon the profession to act in the public interest. Acting in the public interest is a distinguishing hallmark of a profession -- perhaps the distinguishing hallmark, as noted in the first section of this essay. Lord Benson again: "Indeed, it is the duty to serve the public interest which distinguishes a profession from a representative body such as a trade union" (Spada Limited, 2008, p. 38). Not only is it ethically desirable for professions to act in the public interest, but it is necessary for them to do this in order to remain viable. Professions are unlike other goods and services in that they operate on trust. The great majority of the public are forced to trust the professional because they do not have the same amount of knowledge as he or she does in the matter at hand. Patients take it on trust that their doctors know what they are doing -- even when some patients inevitably die or do not improve -- and they continue to engage doctors at the asked-for fees. Litigants take it on trust that their lawyers did the best in the circumstances, even if they were the losing party. If trust is absent, no one will seek the services of the professional -- as exemplified in Semmelweiss' Vienna, where, in a demonstration of public mistrust, women preferred giving birth on the street to being admitted to the hospital because of the infamously high death rates in the maternity ward.
ADA News Bulletin November 2010
ADA News Bulletin February 2011