Professional values: introduction to the theme

Abstract

A code of practice incorporating a declaration of professional values is both a distinguishing feature and its observance a condition of membership of most professional bodies. It is in effect a summary of important aspects of how members of that body are expected to behave and informs not only the membership itself, but also interested others and the general public. Within the values espoused in such codes, we should expect to be able to identify both generic values, that is those that reflect more general commitments to for instance, honesty, integrity, confidentiality and trustworthiness, but also values that relate directly to the nature of that particular profession or related professions. Thus for healthcare professionals, those values associated with beneficence, respect for autonomy and the centrality of patient care are prominent. The group of papers that follows, evolved from a seminar on professional values in health care held at Cardiff University in August 2007 during the annual European Society for Philosophy of Medicine and Health Care conference. They do not represent a comprehensive summary or review of the values expressed in the various healthcare professionals‘ codes—these are readily available in the publications of the respective professional bodies. The intention of the papers is rather to highlight aspects that reflect either an intrinsic process of evolution in professional values, or a response to changing external demands, both welcome and unwelcome. The relevance of reflexive reasoning is a crucial aspect of a profession that is explored by Edgar (2010) who draws on the example of British artists who successfully began a process of transition from trade to profession at the end of the 18th century. Edgar argues that to establish a profession requires not only a theoretically-informed educational base but also should incorporate processes of on-going reflection on professional objectives and just what it means to be a member of that profession. For artists, unlike craftsmen, a search for beauty cannot be codified or defined prior to its realisation. It is asserted that it is this vital element of reflexivity that distinguishes professions including medicine and other healthcare disciplines from occupations dependent on craft skills alone and for which instrumental reasoning is adequate. But paradoxically, a professional risks being disenfranchised from the members of the public he or she serves who are not party to this reflexive element and thus may not share a common vision of what constitutes a satisfactory outcome. Sellman (2010) highlights the tension between institutional (managerial) and nursing (professional) practices in the UK, cautioning that nursing values, and particularly those associated with patient care are under threat from managerial controls. These threats are a consequence of a struggle by managers to accommodate severely constrained financial and human resources in a target-driven culture. Such drives for economic efficiency risk compromising core nursing values. For Sellman, as with Edgar, there is something over and above the mere mastery of technical skills that roughly equates with the internal goods of nursing. Drawing on the work of MacIntyre and others, Sellman argues that a MacIntyrean concept of (external) goods of effectiveness and (internal) goods of excellence D. Badcott (&) Centre for Applied ethics, Cardiff University, Humanities Building, Colum Drive, Cardiff CF10 3EU, UK e-mail: badcottd@cf.ac.uk