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News Bulletin : ADA News Bulletin December 2010
38 DECEMBER 2010 reasons experienced less globalisation. In contrast, the medical profession -- although universally needed -- still tends to act locally. Primary healthcare is not attached to international business and thus its globalisation is taking place more slowly; however, some diagnostic services, such as radiology, are now being delivered remotely through the internet. The professions deal with universal human needs that are understood the world over: health, independent advice, justice, education, ethical conduct, data integrity. The professions lend themselves automatically to globalisation through this attribute of universality. Because of the universal nature of their work, the power that their knowledge gives them and the trust that society reposes in their conduct, professionals have the special obligation to share their knowledge and expertise appropriately -- that is, ethically -- with the world and to its benefit. Indeed, several sources see a lack of ethics as the potential death knell of the professions -- particularly in the global information age. In its study of professionalism, Spada recognizes several threats to the future of professionalism. These threats include consumerism, the desire for instant gratification, lessening client loyalty, declining deference to and respect for authority, increasing media scrutiny and growing regulation. Yet Spada considers ethics to be of the first importance to the future of the professions: "A real or perceived lack of ethical standards should be considered the most serious of threats," for "even more than the high quality provision of services, professional ethics are paramount to maintaining the public trust" (Spada Limited, 2008, p.7). Michael Robinson, a doyen of the Australian legal profession, put this pithily: "Every one has the right to a competent solicitor, but no one can be guaranteed an honest one" (personal communication). The professions are built on trust. The doctor or the lawyer is trusted to do the best he or she possibly can for a good outcome, even if some patients are not cured and if some cases are lost. Trust remains because of a basic faith in the disinterestedness and selflessness that is instinctively sensed as the essence of professionalism. Trust is especially important in an increasingly transparent world, where a damaging reputation can be flashed across the globe via the internet in a few minutes. Erosion of trust due to unethical conduct by professionals can go viral in the wink of an eye. Even when it comes to everyday decisions, people are influenced by ethical considerations. A survey has found that 80% of people said they made a decision to buy from a corporation or firm based upon what they perceive about its ethics. Similarly, 74% of people said they only buy shares in a company known to be ethical (Josephson Institute Report, 2004). Although there is a great deal of trust vested in the professions simply because they are professions, it will reflect poorly on them, and on their prospects, if their practitioners prove themselves unworthy of the societal trust that sustains them. The internet is transforming the way in which the world conducts its transactions. Now a potential client can read extensively about a company or individual by consulting any number of internet sites. Information resources are available beyond a person's or company's own self-reporting on a website that they control. People can now meet and organise through social media and, therein, exercise enormous influence. The internet is a rapidly growing forum. It is estimated that by the year 2011, the internet will reach two billion people, nearly one-third of the world's population. Each year, hundreds of thousands of new blogs are added and, each day, millions of posts occur (Arthur W. Page Society Report, 2007, p. 12). In The Creation and Destruction of Value, Harold James argues that the greatest danger of the current financial crisis is not the destruction of wealth but the destruction of value in the moral sense -- the erosion of trust. There is an uncertainty impinging upon values, prompting people to wonder if the rules of the game still hold. Likening current times to the bank failures of 1931, James says that people are once again drawing back from institutions out of mistrust: "Ethical questions have become again absolutely central... We are back in a world in which trust is a virtue that is required as a logical precondition of being an effective participant in markets" (Alden, 2009). This applies to the professions, which, as we have shown, are experiencing some erosion of public trust. Professionals do not escape unscathed the power of such media as the internet to make or break their own reputations and those of their professions. In addition to having the power to make scandals go viral, the internet has the power to enable knowledge to go viral. Since specialised knowledge is the province of the professions, is the future of professionalism threatened as information is widely disseminated? The democratisation of information and knowledge (and the attendant power) via the internet may be seen as a potential threat to professionalism. The Spada report says: "The internet revolution threatens the information asymmetry that has always been a key feature of the relationship between professionals and clients" (Spada Limited, 2008, p.6). Will professionalism survive the information age? Almost certainly. As much as a person may be able to self-diagnose somewhat through Web MD (the pervasive, contemporary Dr Spock) rather than consulting a doctor, the limits of internet-gained knowledge soon become apparent. Very few of us are likely to hand a scalpel to a friend and ask him or her to Google an appendicectomy. Nevertheless, the professions must recognise that the internet is serving as the cyber Silk Road, disseminating knowledge and putting more of its attendant power into the hands of consumers. Freidson makes an argument for maintaining exclusivity in the professions, saying that it helps maintain the integrity of professional discipline and keeps knowledge undiluted. The popularisation of the knowledge and skills of the professions would not be a good thing, he argues. The elitism of the professions is different from the types of social and political elitism that lead to oppression and exploitation. It is a simple fact that a large proportion of specialised knowledge is more reliable and valid than everyday or popular knowledge. This is simply the division of labour: True inequality of knowledge and judgment in specialized affairs exists by virtue of the very existence of a division of labor. Those who have had intensive training and then work full-time as a specialty can hardly fail to know more about that work than others...such inequality is not unjust, as would be inequality based on race, gender, or other criteria (Freidson, 2001, pp. 203--206). Specialised knowledge, in other words, cannot and should not be democratised. What can be democratised is access to specialised knowledge, or access to professionalism itself. In the information age, it is possible that more and more people can become professionals by gaining specialised knowledge in a specific field of endeavour, through online learning as one avenue. The proliferation of professionalism is the outcome of democratization of knowledge delivery. The professional in one field is a neophyte in all others -- though the internet, and other means of knowledge delivery, may offer neophytes greater access to professional information than has ever previously been possible. If many or most people in the information age attain a type of specialised knowledge, we thus become professionals in one field and informed neophytes in many others, making us, in a sense, more equal. Freidson would agree with the Spada report that more important than safeguarding knowledge and skill is professionalism's attachment to a higher ideal -- this alone assures professionals of the independence and longevity of their profession:
ADA News Bulletin November 2010
ADA News Bulletin February 2011