• Breadcrumb navigation uses Javascript

---

Regulation of the professions & matters of conscience

by Suzanne Ross

What is a profession?

The concept of a profession relates to the contract that professionals make with society. They agree to conscientiously serve the public interest, even when the public interest conflicts with self-interest. Based on this agreement society in return allows the profession certain privileges. The idea of self-regulation that most professions enjoy is one of those privileges. The core of this privilege involves accountability to, and sanctioning by one's professional peers – a professional web that has agreed to serve the common good.

Self-regulation

Human nature is such that we usually want to have our cake and eat it too. We want as much freedom for ourselves as possible whilst maintaining a safe society in which we live, and hence some regulation imposed upon others. This is summed up nicely by Dr Davis McCaughey from the Centre for Philosophy and Public Issues when he wrote:

Conscience is a good thing; regulations are a bad thing – especially if the conscience is mine and the regulations are yours.

Self-regulation, as it relates to professional codes, takes a variety of forms. These codes range from the broad, aspirational approach involving a set of principles, for example 'Do no harm' to a compliance approach involving a list of rules, for example, 'Don't have sex with your patients". It may be appropriate at times to have a clear rule, whereas at other times robotic rule following and unthinking custom and practice can be the enemy of ethics.

Our free ethics counselling service

In general it is not unethical people who ring our free Ethics Counselling service, Ethi-Call, to explore a dilemma but rather those that embrace and engage the ethical dimension within their work and professional lives.

Whilst professional codes attempt to find the appropriate balance of individual freedom, societal expectations and professional regulation, this is not always easy. The escalating changes in an increasingly complex society and the resultant grey areas make it very difficult for a professional code to be an easy rulebook, addressing all dilemmas.

Even if such a complex rulebook could be devised, it would not be appropriate for the profession to impose rules and principles that work in the domain of personal conscience. If you had to choose between the financial cost to your patient and the education of your patient, or helping the sick in underdeveloped countries versus increasing professional expertise to help all patients, what principles or rules do you follow?

We have written a scenario as an example of this.

The prescription-writer's dilemma

'Magi' a pharmaceutical company has developed a permanent cure for cancer. This cure is in a liquid form and if taken three times a day for two months results in a 'permanent' cure. This 'magic elixir' is called BioZapodrine. One year after it was released a number of companies replicated the elixir. You are about to write a script for a patient and have to decide which brand of BioZapodrine you will prescribe. The brands currently on the market are:

Magilix – the originator's brand name, they spent ten years in research and development in order to bring this product through the necessary phases.

Australix – a wholly-owned Australian company which employs a number of Australia's up and coming research scientists.

Pharmalix – the chemists own brand, which is the cheapest available brand.

Aidolix – this company gives free pharmaceutical products to under-developed countries.

Perkolix – this company sponsors many medical conferences and generously gives a variety of sundries, such as cups, pens and chances for free prizes like holidays to the Gold Coast.

Educatolix – this company sponsors many medical conferences and seminars with the intention of increasing professional competency.

Technolix – they subsidise Medical Practice administration costs through the payment of information technology bills, eg. computer and photocopier rental.

Friendolix – you have become really good friends with the company rep.

Rightolix – this company is totally committed to human and animal rights.

Stockolix – you own shares in this company.

Futuralix – a new company who is doing impressive research and development in an area that you consider to be very important.

Supportolix – this company provides excellent written material for the patient, it is clear and concise and is written in eight languages.

For the purposes of this exercise, so that you have to look at the competing principles, it is not enough to simply rotate the prescription around all the manufacturers, nor can you just write the generic name of BioZapodrine which in effect moves the dilemma on to someone else!

So what would you do?

...

discuss this article

---