Experts and Citizens: Rethinking Professionalism
Sullivan, William M., Tikkun
Something has gone wrong with the professions in the United States. Where law, medicine, and the other venerable "learned professions" once served as models of useful knowledge in service to the community, today's entrants to these fields find them beset by cynicism and disillusionment bred of a narrow commercialism. We no longer look to the successful lawyer or doctor for community leadership and public service. Today we worry whether their malpractice premiums are paid up.
The professions' recent record in national leadership is equally embarrassing. During several years of crucial debate over health care, the chief discernable contribution of the American Medical Association, the nation's most powerful professional organization, has been to wheel and deal to enhance its members' incomes. And as newer professions such as engineering, management, and journalism, nursing, and social work have come to the fore, they too appear unsure of their ethical vision. As the social and economic importance of professional work expands, the ethical vision within the professions appears to be contracting.
Many Americans think that there is something wrong with professionals as well. Not financially, of course. Quite the contrary. Professionals make up a large percentage of the fortunate fifth of the nation whose incomes have risen during the past decade, and the top earners among doctors, lawyers, and business executives have been doing even better than the average professional. But most of us, who have been watching our incomes stagnate and decline, now claim to see plenty of things wrong with our professional classes. From lawyer jokes to angry charges of "profscams" in the academy, to outrage at rising medical costs for declining services, professionals are finding their legitimacy threatened, their very professionalism trashed as a cloak for an arrogant ascendancy.
Everybody has good reason to worry about the state of the professions. Because professionals dominate many of the nation's most critical institutions, they play a major role in determining the fate of their fellow citizens. Whether we like it or not, we all depend upon professional competence and probity to get accurate understandings of events, to work and travel safely, to raise families, even to preserve physical and psychic health. How well professionals perform their functions is of serious, sometimes vital, concern to every American. That is why exposes of scientists who falsify crucial research data, or physicians who take financial kick-backs, or lawyers who violate conflict-of-interest codes--all of which now appear with alarming regularity--ignite public anger.
Along with the revelations of malfeasance has come the insidious erosion of morale in many fields. Teachers increasingly find their work unrewarding, doctors urge aspirants not to enter medicine, journalists find their judgment preempted by the conflicting pressures of profitable sensationalism and the constraints of libel law. The health of professionalism is a public concern, and its revival will only be possible when professionals recognize and reassert the public purposes and responsibilities at the core of their enterprise.
Today, the ethical foundation of professional life is at risk. "Professionalism," the competent and ethical application of expert knowledge, traditionally has lent integrity to professional life and made the privileges and status of professionals publicly acceptable. Professionalism is vital because professions can administer their own licensing and standards only so long as they maintain the public trust. So when Americans stop trusting professionals--when they begin to doubt the integrity of the entire field of law or question the reality of professionalism in medicine and a host of other fields--the consequence is a crisis of public confidence that cannot help but determine the future of professional work.
The many manifestations of this crisis flow from a common source. …