Integrity Systems for Occupations

Andrew Alexandra, Seumas Miller

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317115083
• Edition: 1
• Topic: Law
• Subtopic: Jurisprudence
• Index: Law

An integrity system is an integrated assemblage of institutional mechanisms, designed to minimize ethical misconduct and promote ethical health in institutions, organizations, occupations and the like. This book analyses, describes and demonstrates the value of well-designed integrity systems for efficient, effective and ethically sustainable practice, in occupational groups in particular. Developing a blueprint for the design of integrity systems which can be tailored to the specific ethical needs of different occupational groups, this book furthers the general project of ethically informed institutional design ('designing-in' ethics). The approach taken reflects the authors' academic background in professional ethics, as well as their extensive experience in the application of ethical theories and perspectives to the problems and challenges encountered by various occupational groups, such as accountants, business people, lawyers, doctors, nurses, social workers, engineers, emergency service workers and police.

Chapter 1
Professionalization and Occupations

Professions and Occupations

In this chapter, our concern is with occupational and professional roles.1 Shortly, we will distinguish professional roles from other occupational roles. However, first we need to be clear on the notion of an occupational (or professional) role. Roles are teleological in nature; they are distinguished from one another according to the ends or goals they serve.2 Thus, we distinguish the role of a police officer from that of a chef by virtue of the different ends that they serve; police officers act in order to ensure law and order, chefs act in order to provide cuisine.

While it is necessary to differentiate roles, the telos – or end – of a role is not sufficient to distinguish one role from another. Perhaps the end of lawyers, like that of police, is to ensure that the law is upheld. Accordingly, we also need to attend to the means or type of action or activity by which the end of some occupational role is realized. Police, but not lawyers, uphold the law by means of the use, or threat of the use, of coercive force.

So occupational roles are defined in part by the end or ends that they serve, and in part by the types of action or activities that they perform, which are the means to the end(s). In addition, some roles are evidently in part defined by the attitude that practitioners ought to have or adopt. This seems to be true of the caring occupations, e.g. child-minders, nurses, social workers, psychologists.

Historically, a further distinction has been made between occupations and professions. All professional roles are occupational roles, but not all occupational roles are professional roles.

The terms ‘professional’ and ‘profession’ are of course used in a wide variety of ways – we take medicine to be a profession, but also, it would seem, prostitution; we speak of lawyers acting in a professional manner, but we might also say of a carpet-layer that he has done a very professional job.3 Here, however, we use the terms ‘professional’ and ‘profession’ in a relatively restricted way. Our approach to the issue of professional roles involves an investigation of, and generalization from, the characteristic features of such paradigmatic professions as the law, medicine and architecture, and we take it that a person counts as a professional by virtue of their membership of such a profession. Despite regional variations in the organization of, and constraints on, professional work, there is nevertheless a perhaps surprising degree of congruence in such matters, at least in the English-speaking world.

As noted above, a worker will be classified as a member of a particular occupation by virtue of the characteristic activities that they undertake, taken together with the end that those activities serve – gardeners are just those people who tend gardens, cooks those who prepare food, and so on. Likewise, professionals can be identified in part by recourse to the characteristic activities that they perform, and the ends that these activities serve: doctors are just those workers who heal the sick, lawyers those who give legal advice, architects those who design buildings, engineers those who construct buildings, and so on. Such a definition of professionals and professions seems adequate for some of the things that are called as such, such as prostitution, but will not do for the objects of our attention – what we have dubbed the paradigmatic professions. This can be seen by reflecting on the fact that the paid performance of these functions does not necessarily qualify the performer as a professional. To earn that description, the performer also needs to bear various distinguishing social and legal marks. Typically, they have to possess certain educational qualifications, belong to the appropriate professional body and so on.

Indeed, there is a large degree of consensus in the sociological and philosophical literature as to the distinguishing marks of professional occupations.4 Five such marks are especially salient. An occupational group counts as a profession by virtue of its having the following features: the work of its members is oriented to the provision of some good; members of the group possess and exercise creative expertise in the provision of this good; they possess a high degree of autonomy in the exercise of their expertise; they are grouped together as a self-conscious community; and they have a certain institutional status that typically is accorded legal recognition and protection. Let us elaborate further on these distinctive marks of the professions.

First, there is the end of the professions. In one view, the goods towards which the work of members of a professional group ought to be oriented are certain fundamental ethical goods, such as justice and health. Moreover, those who need the fundamental goods in question typically cannot themselves provide them, or at least cannot provide them without assistance. In modern societies, the providers of these goods will often be professionals and professionals have a moral duty to provide these good to those who need them (see the section ‘The Moral Basis of Professional Duties’ below).

Second, the successful prosecution of professional work requires expertise based on a body of specialized knowledge and, therefore, extensive and ongoing, training and education. Moreover, professionals typically require fineness of judgement in the application of this knowledge. These qualities are necessary because of the complexity and yet indeterminate nature of much of a professional’s work. There is, for example, typically no mechanical procedure available to guide the decision as to what is the most appropriate means to the desired end. Consider the work of an architect.

Third, the characteristic skilled creativity of the professional entails a consequent substantial degree of professional autonomy (see the final section of this chapter). With respect to a range of important decisions – for example, whether or not to perform a surgical operation and by what method – the professional is the one to decide, and not (say) the professional’s manager.

Fourth, the skills of the professional can only be developed and transmitted within a group. Professional groups are structured as networks in the sense of economic organizations that exchange goods without explicit equity investment or ownership.5 Professions constitute a community of practitioners who operate separately – indeed often in competition with each other – for many purposes, but are nevertheless dependent on each other for the maintenance and development of their core competencies, and for access to knowledge and expertise. Professionals typically undergo a lengthy, and often ongoing, process of training and accreditation by their fellows. Given the indeterminacy and complexity of much professional work – hence the need for professional autonomy – new knowledge is likely to be generated by individual practitioners in the course of their work, and then transmitted to other members of the network. A doctor, for example, might learn of new developments in his field from a colleague, or seek the professional opinion of other doctors when she is not sure what to make of a puzzling case. And professionals will often depend on references from other professionals for business.

Fifth, the paradigmatic professions, as well as being networked communities in this sense are also institutional entities of a certain sort: members of the profession belong to professional bodies such as the Australian Medical Association.6 The modern professions are typically groups with venerable historical roots, and organizationally they are often continuous with the medieval guilds. Nevertheless, in the institutional form with which we are familiar, they are very much a modern phenomenon. In his study, The Medical Profession in Mid-Victorian England, M.J. Peterson argues, for example, that it was impossible to talk of the medical profession in England at all before the Medical Act of 1858, and even then of dubious value for a considerable time after that.7 What is distinctive, in the first place, about the modern institutions, as against their historical forebears, is their relation to the state – they are legally defined institutions, which is not to say that they are totally constituted by the law.

Therefore a profession comprises persons who are not simply practitioners, but who occupy specific positions and stand in authority relations to others in a structured professional organization and pursue the collective ends of that organization, through such activities as lobbying the government, accrediting individuals and institutions, disciplining miscreant members, as well as ensuring that sufficient practitioners to service the whole community are trained and licensed, and that remuneration for such practitioners is sufficiently attractive to make it likely that they will actually exercise their skills, and so on.

Not only are members of the paradigmatic professions organized into such institutions, it is at least arguable that they should be so organized. Such organization facilitates the achievement of the collective ends of the members of the profession. Members of the profession are well placed to identify the means to the provision of the fundamental goods definitive of that profession as well as the standards and norms of professional behaviour that facilitate the achievement of those goods. The provision of these goods may require actions that reach beyond the provision of service to individuals. The achievement and retention of health is the end of the health professions, for instance. But reaching this end is dependent, in part, on the provision of adequate public health facilities, such as a clean water supply, and an effective sewerage service. As part of their professional role, doctors should be prepared to agitate for such services. Although they can do so as individual members of the profession, they can do so much more effectively as an institution. It is important, then, that professional institutions have an independence from direct political or industrial control, and indeed the capacity to interact with and influence organs of state and commercial power. Moreover, to the extent to which professional institutions are particularly well-placed to identify and enforce appropriate standards and norms of professional behaviour they have a claim to possess self-regulatory powers, and to have input into the design of external regulatory regimes (we discuss professional self-regulation further in the final section of this chapter).

If, indeed, the professions are a distinctive form of occupation with the defining features described above then this will need to be reflected in the various elements of integrity systems constructed to guide them. For example, since the telos – or end – of the work of the professions is a moral good, this should to be stressed in their codes of ethics, as should the distinctive rights of professional practitioners, e.g. professional autonomy. Again, given the role of the professional associations, the codes of ethics of members of the professions will need to have sanctions built into them (see chapters three and four).

We have argued for a distinction between the professions and other occupations. That said, there is no clear dividing line between the professions and other occupations. Rather, there is a set of criteria for being a profession. Many occupations meet some of these criteria, but not all; so they are not professions. Some occupations are such that most of their members meet the criteria; so these are professions. However, some members of these occupations – the occupations that meet the criteria for being professions – do not meet all of the criteria. So there are grey areas. But here, as elsewhere, the existence of greyness does not destroy the distinction between black and white.

The Professions and the Market

The achievement of the institutional status of a professional brings with it a set of rights and duties that are, in a variety of ways, anomalous in comparison to those held by other workers: this anomalous status is in part a consequence of the legal privileges and requirements extended to the profession. Of great importance in this connection is the relationship of the professional to the market.

Historically, professionals have been sheltered in important ways from the disciplines imposed on other occupational groups by market forces. Professions have exercised a legal monopoly or near monopoly (in the case of, for example, lawyers) or a kind of quasi-monopoly (in the case of most other professions) over the provision of services in their area of expertise. There have been at least strong disincentives put in the way of non-professionals entering the market in such services: they have not been allowed to sue for fees owed, for example, and they have not been allowed access to many of the institutional settings where such services are required, irrespective of the wishes of those who consume the services. For example only qualified lawyers can represent others in court for payment,8 and only qualified medical practitioners can treat people in hospitals. Not only have professionals been sheltered from competition with non-professionals, their exercise of the control they are granted as a group over entry into the profession (often called ‘closure’ in the sociological literature) means that they have also tended to be sheltered from vigorous competition within the profession. In such respects, then, professionals appear to have been privileged, relative to most other workers.

There is a tendency within the sociological literature to see the achievement and retention of such privileges as the end of professional organization; and correspondingly to take the attribution of the status of a profession to some occupational grouping as a function of such achievement. In other words a group is counted as a profession because it is privileged, not privileged because it is a profession.9 However, this is only part of the story about the distinctive status of professionals. For if it is true that, in some respects, professionals are privileged relative to other workers, it is also true that in other respects professionals are restricted relative to other workers.

As we have claimed, professionals have been sheltered from the full rigours of the market. It is also the case, however, that they have been denied full access to the potential benefits of the market. Typically, professionals are forbidden from profiting from their expertise in a variety of ways. Of course, they are restricted by the law, as are all workers, but it is worth noting that the consequences of using their skills for illegal ends may be more severe for professionals than for others, since the professional faces not simply the standard legal penalty associated with their wrongdoing, but also the prospect of effectively losing their right to continue to practise their occupation, or the benefits that go with practising their occupation as a member of a profession. In this respect a professional is unlike, say, the farmer who uses specialized knowledge to grow a crop of marijuana. And they may similarly be penalized even if they do things which if they were done by other people would not count as illegal. Lawyers are forbidden, for example, from engaging in action which is judged to be ‘dishonourable’ by a body of their professional fellows (in Victoria, Australia, a committee of the Law Institute), and may have their professional status cancelled or suspended as a consequence of such a judgment.

In some ways, professionals possess less control over the exercise of their occupational skills than most other workers. Doctors can be required to tend the sick and injured (when there is no other qualified practitioner available, for example) whether they want to or not. Lawyers are required to accept clients on a ‘first come, first served’ basis.

One of the consequences of the restrictions on the activities of professionals is that the area of discretion that professionals and their clients possess in regard to their contractual arrangements is also unusually restricted, in comparison with the degree of flexibility typically enjoyed by other service providers and their clients. If a person employs someone to paint their house it can be agreed that they will be paid less than the standard rate, in return, say, for not insisting on the usual degree of finished detail. Professionals and their clients cannot enter into agreements of this form for much of the kinds of work undertaken by professionals. (So a person cannot enter an agreement with their doctor to pay her less than the standard fee for the removal of an appendix, on the condition that she spends no more than an hour on the operation.)

We can conclude that, historically at least, professionals could not plausibly be represented as participants in the open market, negotiating the sale of the use of their skills to the highest bidder.

However, it may well be that, in this regard, things have changed, or are in the process of changing. Certainly, there is pressure on the professions from various quarters, for instance in Australia from the Australian Competition and Consumer Commission, to adopt a more competitive market-centred model. Moreover, many professionals are now employed in large business corporations, and in this context there is a tendency to see their work as no different from that of any other employee, in that it is supposed to contribute to the economic ‘product’ of the corporation which pays them. These forces are now so strong that in some quarters there is talk of the ‘de-profes...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Acknowledgements
• Introduction
• 1 Professionalization and Occupations
• 2 Holistic Integrity Systems
• 3 Codes of Ethics
• 4 Complaints and Discipline Systems
• 5 Ethical Reputation Indexes and Ethics Audits
• 6 Empirical Research, Ethics and Occupations
• Bibliography
• Index