What purpose is served by renovation or redesign of professionalism, and how successful a process is it likely to be? This article addresses these questions by examining the effectiveness as a professional development mechanism of the imposition of changes to policy and/or practice that require modification or renovation of professionalism. The 'new' professionalisms purported to have been fashioned over the last two or three decades across the spectrum of UK education sectors and contexts have been the subject of (...) extensive analysis, and this article avoids going over old ground and revisiting issues that have already been much debated. Nevertheless, the example of UK government education policy during this period is used as a basis for considering the pitfalls associated with mechanisms for modifying professionalism through a reform and standards agenda. The article's analysis incorporates redefinition and examination of the concept and substance of professionalism and offers new perspectives in the form of three distinct conceptions: demanded, prescribed and enacted professionalism. Exploring the existentialist status of 'new' or 'modified' professionalisms and the relationship between professionality, professional culture and professionalism, it examines how professionalism may be interpreted and utilised for the development of education professionals. (shrink)

As in other societies, medical professionalism in the Peoples’ Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, “Medical Professionalism in the New Millennium: A Physician Charter,” by the Chinese Medical Doctor Association (hereafter, the Charter). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians’ attitudes toward the fundamental principles and core commitments put forward in the (...) Charter. Based on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients’ autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically—recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism—a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine crosscultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. (shrink)

Responsibility and professionalism are increasingly issues of concern for professional associations, employers and educators alike. When bad things happen, professionals are often held personally accountable for complex situations. Professional Responsibility and Professionalism advances our approaches to professional responsibility from individual-centred, virtue-based prescriptions towards understanding and responding effectively to the multifaceted challenges encountered today by professionals working in dynamic complexity. The author applies a sociomaterial examination to specific examples drawn from different professional contexts of practice. She examines important implications (...) for what professional responsibility and accountability might mean individually and collectively, and what it might be becoming when demands increasingly conflict, and when we accept that capacities for action are performed into existence in emergent and precarious webs of both human and non-human forces. The chapters explore some of the most prominent questions in professional responsibility, including: What does professional responsibility, and accountability, mean in the escalating complexities and conflicts confronting today's professionals? How does professional responsibility become developed and enacted, and through what social and material entanglements? How should responsibility be determined in multi-agency and interprofessional practice? What happens when professional decisions are delegated to software algorithms and diagnostic instruments? How are new governing regimes of professional work, such as innovation imperatives, excessive audit and logics of blame and scapegoating, reconfiguring responsibility? How can professionals respond simultaneously to individuals in need, the obligations of their profession, the demands of their employer and an anxious society? A major concern addressed by each chapter, and the book as a whole, is educating professionals in and for responsibility. Specific dilemmas and strategies are offered for educators in universities, workplaces and professional development contexts who seek new approaches to helping professionals learn to critically understand and practise responsibility today. This book will appeal to a wide audience of education researchers and post-graduate students studying professional practice, professionalism and education across a wide range of disciplines. Health professionals, professionals working in private practices, such as law, architecture and engineering, newer professions such as social work and policing, and educational professionals at all levels will find stories and strategies reflecting key issues of their practice in this detailed exploration of professional responsibility and accountability. (shrink)

Health care systems are widely criticized for limiting doctors' roles as patient-advocates. Yet unrestricted advocacy can be unfairly partial, costly, and prejudicial. This essay considers three solutions to the problem of how to reconcile the demands of a just health care system for all patients, with the value of advocacy for some. Two views are considered and rejected, one supporting unlimited advocacy and another defending strict impartiality. A third view suggested by Hume's moral theory seeks to square the moral demands (...) of professional advocacy and just health care systems. A moral basis for limited advocacy exists when it can be justified from a general or moral vantage. Consequently, ethical aspects of professionalism are not necessarily on a collision course with health care systems incorporating managed care. This solution is compatible with goals regarding the importance of humanistic education and professionalism to build patients' trust. (shrink)

We argue that a turn toward virtue ethics as a way of understanding medical professionalism represents both a valuable corrective and a missed opportunity. We look at three ways in which a closer appeal to virtue ethics could help address current problems or issues in professionalism education—first, balancing professionalism training with demands for professional virtues as a prerequisite; second, preventing demands for the demonstrable achievement of competencies from working against ideal professionalism education as lifelong learning; and (...) third, avoiding temptations to dismiss moral distress as a mere “hidden curriculum” problem. As a further demonstration of how best to approach a lifelong practice of medical virtue, we will examine altruism as a mean between the extremes of self-sacrifice and selfishness. (shrink)

Neuroscientists are increasingly put into situations which demand critical reflection about the ethical and appropriate use of research tools and scientific knowledge. Students or trainees also have to know how to navigate the ethical domains of this context. At a time when neuroscience is expected to advance policy and practice outcomes, in the face of academic pressures and complex environments, the importance of scientific integrity comes into focus and with it the need for training at the graduate level in the (...) responsible conduct of research . I describe my experience teaching RCR in a graduate neuroscience program and identify three personal reflections where further dialogue could be warranted: mobilizing a common set of competencies and virtues standing for professionalism in the neurosciences; tailoring RCR for the neurosciences and empowering students through the active engagement of mentors; soliciting shared responsibility for RCR training between disciplines, institutions and governmental or funding agencies. (shrink)

Contemporary accounts of medical ethics and professionalism emphasize the importance of social justice as an ideal for physicians. This ideal is often specified as a commitment to attaining the universal availability of some level of health care, if not of other elements of a “decent minimum” standard of living. I observe that physicians, in general, have not accepted the importance of social justice for professional ethics, and I further argue that social justice does not belong among professional norms. Social (...) justice is a norm of civic rather than professional life; professional groups may demand that their members conform to the requirements of citizenship but ought not to require civic virtues such as social justice. Nor should any such requirements foreclose reasonable disagreement as to the content of civic norms, as requiring adherence to common specifications of social justice would do. Demands for any given form of social justice among physicians are unlikely to bear fruit as medical education is powerless to produce this virtue. (shrink)

Candor stands as the keystone element in creating the foundation of trust in the Army, yet the topic is muted. Stewards of the Army Profession build trust through authentic communication -- in education, training, and modeled in application. Candor was previously included in Army Doctrine, yet nearly no mention of it currently exists in professional military education and dialogue. Through personal experiences and review of literature, two examples -- the demands placed on the Army Reserve Components and a review of (...) the Army's counseling and evaluation environment -- serve as illustrations where candor requires revitalization. Candor must be reinforced to be valued or it remains peripheral, serving as a lesson that is equally damaging to individual character as is it institutionally to the Army. (shrink)

Eine Debatte ist ein öffentliches Streitgespräch, das gewissen Regeln folgt. Das Ziel einer Debatte ist nicht die Lösung eines Problems, wie in einer Diskussion, sondern Positionen zu markieren. In einer Debatte zählen nicht nur Argumente, sondern auch Polemik und der Mut zur These. Eine produktive Debatte bedarf neben von allen Teilnehmern akzeptierten Regeln auch einer sog. Debattenkultur. Christian Demand und Ekkehard Knörer führen eine Debatte zur Etablierung dieses Begriffs in den 1980er Jahren und entwickeln Thesen zu deren angeblichen Verschwinden durch (...) die Beschleunigung von Debatten unter den Bedingungen der »Neuen Medien«. A debate is a public dispute that follows certain rules. The goal of a debate is not the solution of a problem as in a discussion, but to point out positions. In a debate, not only arguments, but also polemics and the courage to take a stand are essential. Besides certain rules that are accepted by all participants, a debate needs a so-called debate culture in order to be productive. Christian Demand and Ekkehard Knörer lead a debate on the establishment of this concept in the 1980s and develop theses for its alleged disappearance caused by the acceleration of debates under the conditions of “new media.”. (shrink)

A debate is a public dispute that follows certain rules. The goal of a debate is not the solution of a problem as in a discussion, but to point out positions. In a debate, not only arguments, but also polemics and the courage to take a stand are essential. Besides certain rules that are accepted by all participants, a debate needs a so-called debate culture in order to be productive. Christian Demand and Ekkehard Knörer lead a debate on the establishment (...) of this concept in the 1980s and develop theses for its alleged disappearance caused by the acceleration of debates under the conditions of “new media.”. (shrink)

The activities of the life sciences are essential to provide solutions for the future, for both individuals and society. Society has demanded growing accountability from the scientific community as implications of life science research rise in influence and there are concerns about the credibility, integrity and motives of science. While the scientific community has responded to concerns about its integrity in part by initiating training in research integrity and the responsible conduct of research, this approach is minimal. The scientific (...) community justifies itself by appealing to the ethos of science, claiming academic freedom, self-direction, and self-regulation, but no comprehensive codification of this foundational ethos has been forthcoming. A review of the professional norms of science and a prototype code of ethics for the life sciences provide a framework to spur discussions within the scientific community to define scientific professionalism. A formalization of implicit principles can provide guidance for recognizing divergence from the norms, place these norms within a context that would enhance education of trainees, and provide a framework for discussing externally and internally applied pressures that are influencing the practice of science. The prototype code articulates the goal for life sciences research and the responsibilities associated with the freedom of exploration, the principles for the practice of science, and the virtues of the scientists themselves. The time is ripe for scientific communities to reinvigorate professionalism and define the basis of their social contract. Codifying the basis of the social contract between science and society will sustain public trust in the scientific enterprise. (shrink)

Teachers in many countries complain that their pedagogic work is impeded by unreasonable bureaucratic demands by government agencies. This paper suggests that historical, institutional and cultural perspectives are needed to understand the processes at work. It draws on Weber’s classic study of bureaucracy, but also makes reference to claims that traditional bureaucracies have been modified in ways that ameliorate their authoritarian character. The central part of the paper examines the attempts of one country (Scotland) to address complaints about excessive bureaucracy: (...) it is argued that they show a limited understanding of the nature of institutional power. In the discussion that follows, a number of critical interpretations are considered: that bureaucracies are, by their very nature, anti-educational; that they undermine ethical consciousness and cause psychological damage; and that enhanced professionalism can serve as a counterweight to bureaucratic tendencies. The paper ends by suggesting that the powerful pragmatic argument that mass, state-run educational systems cannot function without complex administrative structures, should not be used to disguise the fact that they have unintended consequences, some of which tend to subvert their stated aims. (shrink)

In professional medical ethics, the physician traditionally is obliged to fulfil specific duties as well as to embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired moral attitude of physicians. In a series of three articles, three of the discussed concepts are presented in an interpretation that is meant to characterise the morally emotional part of this attitude: “empathy”, “compassion” and “care”. In the first article of the series, “empathy” has been (...) developed as a mainly cognitive and morally neutral capacity of understanding. In the second article, the emotional and virtuous core of the desired professional attitude—compassion—has been presented. Compassion as a professional attitude has been distinguished from a spontaneous feeling of compassion, and has been related to a general idea of man as vulnerable and solidary being. Thus, the dignity of the patient is safeguarded in spite of the asymmetry of compassion. In this article, the third concept of the triad—“care”—is presented. Care is conceived as an attitude as well as an activity which can be directed to different objects: if it is directed to another sentient being, it is regarded as intrinsically morally valuable; implying (1) the acceptance of being addressed, (2) a benevolent inclination to help and to foster, and (3) activity to realize this. There are different forms of benevolence that can underlie caring. With regard to the professional physician’s ethos, the attitude of empathic compassion as developed in the two previous articles is proposed to be the adequate underlying attitude of care which demands the right balance between closeness and professionalism and the right form of attention to the person of the patient. ‘Empathic compassionate care’ does not, however, describe the whole of the desired attitude of a physician, but focuses on the morally-emotive aspects. In order to get also the cognitive and practical aspects of biomedicine into the picture, ‘empathic compassionate care’ has to be combined with an attitude of responsibility that is more directed to decision-making and outcome than a caring attitude alone can be. The reconstruction of the desired professional attitude in terms of “empathic compassionate care” and “responsibility” is certainly not the only possible description, but it is a detailed proposal in order to give an impulse for the discussion about the inner tacit values and the meaning of medicine and clinical healthcare professions. (shrink)

In the highly competitive global market, characterized by rapid political, economic, environmental and technological changes, there has been an increased interest in the role of ethics for shaping corporate actions and highlighting the essential tasks and measures to fulfill two generic missions: support enterprises to make distinctive, lasting and substantial improvements in their performance and build a great firm that attracts, develops, excites and retains exceptional people. This paper addresses the issues arising from opposing forces, namely on the one hand (...) the extremely challenging external environment and on the other hand the increasing demand for responsible business behaviour and ethical decision-making focused on the shared and sustained value creation to serve the interests of all stakeholders, society and the environment. Primary objective is to provide coherent and compact definitions for the key values dealing with professionalism, equality and sustainability that should be clearly defined, thus providing the key drivers for creating a working environment that inspires and motivates employees on one hand; and promote each enterprise socioeconomic footprint in the regional and global business ecosystem. When handling the concepts of responsibility, ethical codes, integrity or trust, philosophy provides an invaluable framework and a foundational basis on which to create and maintain sustainable structures and processes for the business of the new era. (shrink)

During the past few months, the discussion over the physicians' “Right of Conscience” has been on the rise. The intervention of politics in this issue shifts the discussion to a very specific and narrow area, namely the “reproductive health laws” which bear well-known predisposing attitudes.In this article, the physician's ROC is discussed in the context in which it naturally belongs: the Patient Physician Relationship . I suggest that the physicians' rights demand is a comprehensible, predictable, and even inevitable step as (...) part of the “evolution” of the PPR. Thus, the most appropriate way to comprehend and tackle the demand for physicians' ROC is within the context of medical professionalism. While searching for practical solutions to the “reproductive health” problems, there is a need to recognize the ethical and practical implications of the change in the PPR and balance between patient and physician rights. (shrink)

The authors discuss findings from a qualitative research project concerning applied ethics that was undertaken at a general family counseling agency in southern Ontario. Interview data suggested that workers need to dialogue about ethical dilemmas, but that such dialogue demands a high level of risk taking that feels unsafe in the organization. This finding led the researchers to examine their own sense of "breaking rules" by suggesting an intersubjective view of ethics that requires a "safe space" for ethical dialogue. The (...) authors critique the individualistic tendency of professional ethics as an effect of power that is tied to the history of professionalism, and discuss the role of bureaucracies in diminishing a central role for ethics in helping services. The authors call for elaboration of critical perspectives on ethics in order to promote the centrality of ethics in the helping professions. (shrink)

Virtue ethics has long provided fruitful resources for the study of issues in medical ethics. In particular, study of the moral virtues of the good doctor—like kindness, fairness and good judgement—have provided insights into the nature of medical professionalism and the ethical demands on the medical practitioner as a moral person. Today, a substantial literature exists exploring the virtues in medical practice and many commentators advocate an emphasis on the inculcation of the virtues of good medical practice in medical (...) education and throughout the medical career. However, until very recently, no empirical studies have attempted to investigate which virtues, in particular, medical doctors and medical students tend to have or not to have, nor how these virtues influence how they think about or practise medicine. The question of what virtuous medical practice is, is vast and, as we have written elsewhere, the question of how to study doctors’ moral character is fraught with difficulty. In this paper, we report the results of a first-of-a-kind study that attempted to explore these issues at three medical schools in the United Kingdom. We identify which character traits are important in the good doctor in the opinion of medical students and doctors and identify which virtues they say of themselves they possess and do not possess. Moreover, we identify how thinking about the virtues contributes to doctors’ and medical students’ thinking about common moral dilemmas in medicine. In ending, we remark on the implications for medical education. (shrink)

The ethical choices faced by engineers today are increasingly complex. Competing and conflicting ethical demands from clients, communities, employees, and personal objectives combine to suggest that engineers employ ethical approaches that are adaptive yet grounded in three concrete professional circumstances: first, that engineers apply unique professional skills in the service of a client, subject to protecting the public interest; second, that engineers advance the state of knowledge of their professional field through reflection, research, and sharing experience in journals and conferences, (...) and third, that they develop new professionals by active mentoring. This paper examines five features of American pragmatism and suggests that its emphasis on specific, context-based ethical decision making can assist engineers in a postmodern setting. In particular, it considers the venues of interpersonal ethical choices, institutional ethical conflicts, and social choices that have ethical components. Pragmatism suggests that in such a complex ethical climate, there is a need for the co-evolution of judgment and action, for individual reflective judgment in particular situations, and for ceasing to search for a single, immutable principle for ethical choice. (shrink)

Background: Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent. Objectives: The goal was to understand caregivers’ concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of professional (...) ethics within the care setting. Research design: A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland. Participants and research context: A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels. Ethical considerations: Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland]. Findings: Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation. Discussion: Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics. Conclusion: Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities. (shrink)

Cet article porte sur les aspects non communicationnels du métier des professionnels de la traduction. Les différents métiers de la traduction exigent des compétences linguistiques en réalité très diversifiées. Des données récentes, notamment d’Europe et d’Amérique du Nord, démontrent l’importance du « secteur des services linguistiques ». Si l’on dispose assez largement de statistiques fiables sur l’ampleur du marché de la traduction dans les pays développés, on n’en a pratiquement aucune pour les pays en voie de développement, même les plus (...) grands. Nous savons très peu de choses des conditions de travail des traducteurs, mais une récente étude européenne montre qu’en général les traducteurs littéraires sont mal payés et souvent soumis à de lourdes charges de travail, ce qui nuit à la qualité. D’autres études sont manifestement nécessaires. La Fédération internationale des traducteurs vise à promouvoir le professionnalisme des métiers de la traduction et l’amélioration des conditions de travail des traducteurs en rassemblant les diverses associations nationales. Néanmoins, les instances dirigeantes de cette fédération sont dominées par l’Europe et les États-Unis alors même que l’on assiste à l’émergence de nouvelles puissances sur la scène mondiale et que les besoins en traduction ne cessent d’augmenter : ce sont de tels déséquilibres que l’article entend également aborder.This article looks into the non-communicational aspects of the work of translating professionals. Translators work in a variety of jobs that require a range of language skills. Recent data, particularly from Europe and North America, demonstrate the economic importance of the “language services industry”. Reliable statistics on the size of the labour market are available principally from developed countries, but there is a lack of such data on even the largest developing countries. We know very little about the working conditions of translators; however, a recent European survey indicates that, in general, literary translators are poorly paid and frequently required to take on heavy work loads, with negative consequences for quality. More studies are clearly necessary. As a forum for national translators’ associations, the International Federation of Translators promotes professionalism in the translating field and proper working conditions for translators. However, the FIT’s governing bodies are dominated by Europe and North America, despite the rise of the new economic powers and the increase in demands for translation. This paper also discusses some of the consequences of these imbalances. (shrink)

The current state of Ukrainian society is characterized by socio-economic instability, there are dynamic, unique processes in which each person is involved. In this connection, there are increasing demands on the professionalism of specialists in the field of practical psychology, their philosophical counseling in the context of postmodernism, aimed at helping people become the subject of their life, work, social and value relationships, to teach them to find meanings and maximize self-actualization. This is represented in the change of priorities (...) in the professional development of practical psychologists, its focus on the development of specialists' subjectivity, their ability to independently solve professional and life tasks. An important role in enhancing the development of professionalism is the understanding of the essential characteristics of existential professional activity, expressed most often in professional meanings and values. The basis of a meaningful professional and personal life is the key ability of the practical psychologist to see and accept the needs of the profession and life and to find the most correct explanations for them. The purpose of the article is to investigate the importance and necessity of the activity of a practical psychologist, its peculiarities, the study of types of psychological aid: counseling, psychological rehabilitation, correction, psychotherapy, training, education and prevention; as well as the need to identify the main areas of professional activity of practical psychologists in the context of postmodernism. (shrink)

El objetivo del trabajo fue fundamentar las bases teóricas que sustentan la importancia del trabajo independiente en el proceso de enseñanza aprendizaje en la Educación Médica Superior, así como aspectos relativos a su concepción, requerimientos y formas de aplicación. Se realizó un estudio bibliográfico acerca del tema y se llegó a las siguientes conclusiones: el trabajo independiente es un medio de organizar metodológicamente la actividad cognoscitiva independiente de los estudiantes que se expresa a través de un conjunto de tareas y (...) puede utilizarse durante la actividad docente y fuera de ella, así como en cualquiera de las formas de organización de que se trate. Es imprescindible que se tengan en cuenta al organizar el trabajo independiente las etapas de la actividad humana: planificación, orientación, ejecución y control. El trabajo independiente es un factor importante para estimular la independencia de los futuros profesionales de las Ciencias Médicas por lo que su perfeccionamiento exige al profesor una alta profesionalización de sus acciones. The objective of the work was to stablish the theorical bases that sustain the importance of the independent work in the teaching learning process in the medical education, as well as, relative aspects to its conception, requirements and application forms. A bibliographical study about the topic was carried out reaching the following conclusions the independent work is a way of organizing methologically the independent cognitive activity of the students that is expressed through out a group of tasks and it can be used during the teaching - learning in and out of the classroom; as well as in any of the forms of teaching organization. It is indispensable when organizing the independent work of the students to keep in mind the different stages of the human activity planning, orientation, execution and control. The independent work is an important factor to stimulate the independent of the future professionals of the medical sciences that is why its improvement demands a higher professionalism of its actions. (shrink)

In theory, physicians subscribe to and in their actions personify a set of virtues whose performance demands personal engagement. At the same time, they are instructed in their professional roles to remain emotionally and personally distant from those they are called to treat. The result, the authors argue, is an ethical conflict whose nature is described through an analysis of two narratives drawn from an online blog for young physicians. Confusion over professional responsibilities and personal roles were found to affect (...) physicians' perceptions of their clinical duties and their social roles. In addition, it sets in sharp relief contemporary debates on physician training and the ethical nature of medical professionalism. Practically, the authors suggest, the confusion may contribute to early physician burnout. Methodologically, this paper promotes the use of online discussion sites as rich repositories providing an insight into real dilemmas and the actual perception of physicians' attempts to address them. It thus promotes use of such sites as a resource in which assumptions about physicians' own perceptions about the nature of their role in contemporary society can be tested. (shrink)

When physicians today appeal to “conscience,” it has been alleged such exercises pejoratively reflect “conscience without consequence” as contemporary practitioners are said to be insulated from the consequences of such decisions. It has also been implied these physicians avoid traditional professional responsibilities—including providing charity care and making house or night calls. The assertions demand clarification. Fundamentally, what traits constitute an integrated professionalism specific to Christian physicians? Historical evidence verifies sanctity-of-life affirmations by Christian physicians throughout Church history. However, surveying Christian (...) medical practices in the initial centuries of the Common Era, and more recently in the United States, supports integration of conscience with philanthropy and a rigorous definition of a medical vocation. These suggest there may be deterioration in a holistic commitment to medicine in the United States. Reclaiming an integrated professional paradigm—wherein conscience, philanthropia, and vocation are combined—is essential to an authentic contemporary witness. (shrink)

In Italy in recent years, an exponential increase in the frequency of medical malpractice claims relating to the issue of informed consent has substantially altered not only medical ethics, but medical practice as well. Total or partial lack of consent has become the cornerstone of many malpractice lawsuits, and continues to be one of the primary cudgels against defendant physicians in Italian courtrooms. Physicians have responded to the rising number of claims with an increase in ‘defensive medicine’ and a prevailing (...) preoccupation with the purely formal aspects of consent. The result is a plethora of consent forms, believed to be a guarantee of ‘informed consent’, as well as a growing reliance on informed consent as a shield against judicial action brought by the patient. Physicians ‘inform’ patients without really sharing information, often delegating the task of communication to other professionals who are not doctors. Italian judges always condemn the physician when information to the patient has been inadequate, thus leading insurance companies to consider the lack of valid informed consent as the total responsibility of the physician and/or the hospital. It is necessary to change tack, to remove this idea of consent which permeates the defensive culture of medical practice. Italian physicians need to be trained, first of all, to become aware that information and consent are two distinct processes, albeit closely connected. Valid communication demands a higher level of professionalism from physicians. (shrink)

This book seeks to reframe our understanding of the lawyer's work by exploring how Martin Luther King, Jr built his advocacy on a coherent set of moral claims regarding the demands of love and justice in light of human nature. King never shirked from staking out challenging claims of moral truth, even while remaining open to working with those who rejected those truths. His example should inspire the legal profession as a reminder that truth-telling, even in a society that often (...) appears morally balkanized, has the capacity to move hearts and minds. At the same time, his example should give the profession pause, for King's success would have been impossible without his substantive views about human nature and the ends of justice. This book is an effort to reframe our conception of morality's relevance to professionalism through the lens provided by the public and prophetic advocacy of Dr King. (shrink)

From microcosm to macrocosm, ecodesign, green design, environmental design, and triple bottom line are quickly becoming more than just catchy phrases that describe touchy-feely trends. Increases in climate uncertainty and energy costs as well as food, water, and services insecurity are just a few of the challenges driving the growing demand for sustainable design outcomes. Sustainability and Design Ethics provides a systematic value analysis that makes a reasoned argument the rethinking of current design methods and the values and ethics which (...) guide them. Providing context and language, this book delineates the ideas and principles that lie at the foundation of a variety of codes of ethics, and then critically analyzes existing published codes and the practices that stem from them. It takes a practical approach, discussing applied ethics, and relies upon an understanding of the moral reasoning that supports the ideas and professionalism and an ethical standard of care. Drawing on the author's experience as a design professional and his study of business ethics, this book supplies a detailed exposition of the underlying ethical reasoning involved in the challenges confronted by contemporary design professionals. This information can then be distilled into sustainable practices and the corresponding ethics. Sustainability requires design professionals to expand the considerations of design beyond the traditional ethical points of view and to provide a balanced analysis of how a sustainable standard of care might be composed. While other books might cover the environment and design, professional ethics are addressed as an afterthought at most, if at all. And no other book available explores sustainability from a designer’s perspective. Examining present and future issues facing practitioners, the book provides a context for the values and ethics necessary for sustainable development design. (shrink)

In this article I discuss the ethical ramifications for medical ethics training of the availability of large language models (LLMs) for medical students. My focus is on the practical ethical consequences for what we should expect of medical students in terms of medical professionalism and ethical reasoning, and how this can be tested in a context where LLMs are relatively easy available. If we continue to expect ethical competences of medical professionalism of future physicians, how much – if (...) at all – should we worry that such generative AI may compromise adequate testing of medical students’ abilities in this regard? I mainly focus on assessment methods based on written assignments of the ‘student paper’ type and consider whether LLMs make it unfeasible for assessors to gauge whether output is student-generated or ‘machine-generated’ and, if so, whether this is a problem. My take on this research question unfolds in three interwoven arguments, claiming that the advent of LLMs may offer a momentum (i) to reaffirm the importance of context-sensitive interpretation and specification of ethical principles in medical ethics training, (ii) to provide more supportive circumstances to assessors to allow them to meet scoring demands entailed by the importance that is placed on medical professionalism, and (iii) to complement written assignments with verbal (group) discussion to train and test students’ skills to habitually recognize that ‘moral solutions’ can be normatively questioned and specified from various perspectives. (shrink)

Professional medical ethics demands of health care professionals in addition to specific duties and rules of conduct that they embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired implied attitude of physicians. In a sequel of three articles, a set of three of these concepts is presented in an interpretation that is meant to characterise the morally emotional part of this attitude: “empathy”, “compassion” and “care”. In the first article of the (...) series, “empathy” has been developed as a mainly cognitive and morally neutral capacity of understanding. In this article, the emotional and virtuous core of the desired professional attitude—compassion—is elaborated. Compassion is distinguished from sympathy, empathy and pity. Several problems of compassion as a spontaneous, warm emotion for being a professional virtue are discussed: especially questions of over-demand, of justice and of concerns because of a possible threat to the patient’s dignity and autonomy. An interpretation of compassion as processed and learned professional attitude, that founds dignity on the general idea of man as a sentient being and on solidarity, not on his independence and capacities, is developed. It is meant to rule out the possible side effects and to make compassion as a professional attitude and as professional virtue attractive, teachable and acquirable. In order to reach the adequate warmth and closeness for the particular physician-patient-relation, professional compassion has to be combined with the capacity of empathy. If appropriate, the combination of both empathy and compassion as “empathic compassion” can demand a much warmer attitude towards the patient than each of the elements alone, or the simple addition of them can provide. The concept of “care” that will be discussed in a forthcoming article of this sequel is a missing necessary part to describe the active potential of the desired moral attitude of the physician more completely. The reconstruction of the desired professional attitude in terms of “empathic compassionate care” is certainly not the only possible description, but it is a detailed proposal in order to give an impulse for the discussion about the inner tacit values and the meaning of medicine and clinical healthcare professions. (shrink)

The paper examines three factors that are driving and constraining the development of rural legal services delivery in China: geographic limitation, professional interest and political intervention. Firstly, geography matters and rurality creates natural barriers for rural residents in limiting the access to legal services. There is an inherent spatial inequality for rural population when it comes to the distribution of legal service and the geographic isolation and remoteness nurture a particular type of legal culture among rural residents. Secondly, professionalism (...) matters. There are strong ideological and economic forces which pull the rural legal service providers away from their grass-roots. The calling of an emerging legal professionalism (and the related financial incentives) demands a certain degree of legal knowledge and qualification, rules of procedures, code of conduct and regularity in legal practice. In order to survive in an increasingly competitive legal market, rural legal service providers have to run legal practices as a business, considering the "bottom line" and following the logic of a legal market. Finally, politics matters. To overcome geographic barriers and correct market failure, the government would need to steps-in to provide or supplement legal service in rural areas by introducing a public dimension of legal services. Politics may ameliorate where the legal service market fails. (shrink)

The paper examines three factors that are driving and constraining the development of rural legal services delivery in China: geographic limitation, professional interest and political intervention. Firstly, geography matters and rurality creates natural barriers for rural residents in limiting the access to legal services. There is an inherent spatial inequality for rural population when it comes to the distribution of legal service and the geographic isolation and remoteness nurture a particular type of legal culture among rural residents. Secondly, professionalism (...) matters. There are strong ideological and economic forces which pull the rural legal service providers away from their grass-roots. The calling of an emerging legal professionalism (and the related financial incentives) demands a certain degree of legal knowledge and qualification, rules of procedures, code of conduct and regularity in legal practice. In order to survive in an increasingly competitive legal market, rural legal service providers have to run legal practices as a business, considering the "bottom line" and following the logic of a legal market. Finally, politics matters. To overcome geographic barriers and correct market failure, the government would need to steps-in to provide or supplement legal service in rural areas by introducing a public dimension of legal services. Politics may ameliorate where the legal service market fails. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Art Subjects: Making Artists in the American UniversityTheodore GracykArt Subjects: Making Artists in the American University, by Howard Singerman. Berkeley, Los Angeles, London: University of California Press, 1999, 296 pp., $19.95 paper.Howard Singerman's Art Subjects is a study of the training of visual artists in American universities from 1912 to the present. More precisely, the book is an account of how two philosophies ofeducation have competed to inform (...) that training. At the outset, Singerman announces that the book explores a long-standing "struggle between vision and language" (p. 10) that culminates with a decisive privileging of language. The book mimics its putative subject in at least one interesting way. As it was for art and the training of American artists in the twentieth century (at least on Singerman's account of them), so it is with the book. Each moves from a practice grounded in objective reality to a jargon-ridden discourse that limits entry to anyone outside of its acutely self-regarding disciplinary field. Although the book's acknowledgments segment thanks one individual for demanding thatSingerman "come to a real conclusion" for the book, readers should note Singerman's subsequent admission that it may not have one. At times it even appears that Singerman goes out of his way to avoid drawing one.Art Subjects appears to have started life as Singerman's doctoral dissertation, but it only occasionally displays the dull by-the-numbers writing of such documents. The book has a clear organization and its numerous quotations are carefully documented. The overall argument is framed, beginning and end, with Singerman's autobiography of his own time as a university art student. It provides him with his framing question: if he has a M.F.A. in sculpture but never learned to sculpt, what does his professional degree signify? The answer is that it indicates that his work is no longer facile. He has progressed from the realm of the artist whose work is professional, displaying facility, to the stage where he is professional. He has progressed to the point where being an artist is theartist's true subject: "Artists are the subject of graduate school; they are both who and what is taught" (p. 3). If this progression is best indicated by an artist's lack of facility in producing works of art, that is the price of professionalism. In the post-World War II university, art training is "founded on the primacy of theory over practice" (p. 181). Yet the result is professionalism without a clear profession other than as an employee of the post-World War II university: the M.F.A. prepares artists for the university discipline of art. Citing Foucault, Singerman seems satisfied that artists have taken command of a theoretical field. Disciplinary boundaries are created and policed by its rules of professional discourse. At the same time, Singerman declares his intention to "use the concept of the discipline as it constrains and structures discourses to keep from having to judge whether or not art is a profession" (p. 201). He likewise mentions [End Page 119] but does not take any stand on the "putative decline of recent art" (p. 210). This ongoing refusal to judge deprives the book of potentially interesting conclusions. It also calls into question Singerman's repeated references to the "self-criticality" of the discipline.Singerman's neutrality might berefreshing were it not for his use of Foucault to introduce the notion that each new "proposition" within the disciplinary discourse represents progress in a "theoretical field," moving "knowledge" forward. Talking about art (and not, to be sure, talking all that much about specific works of art) and talking about being an artist may or may not represent progress. For instance, Singerman's early chaptersmake the case that the triumph of artistic modernism must be understood as a repudiation of a "female" aesthetic and even of women as artists. Singerman returns to the topic ofwomen artists only once, to note Griselda Pollock's approval of the entry of feminism into the academic discipline of art. Thus Singerman is silent on the question of whether progress is made when the number of women is... (shrink)