Ethics: The foundation of a profession
By Mark E. Meaney, PhD, Health Care Ethicist
Center for Ethics in Health Care
St. Joseph’s Health System, Atlanta
Case managers have established their own standards of practice and accreditation processes. They have developed guidelines to regulate entry into the field and discipline members. These are essential steps in the development of a profession. However, the hallmark of a profession is a code of ethics. With power and privilege comes responsibility for members of professions. In exchange for autonomy, society expects members of professions to set higher standards of conduct than those required of others. A profession’s code of ethics exhibits this "implied contract."
Professional ethical development begins with the formation and distribution of a code of ethics. (For more on the evolution of case management as a profession, see Case Management Advisor, December 1997, pp. 201-205, and January 1998, pp. 1-3.) To serve as the basis of a claim to autonomy from social control, a code of ethics should:
• regulate the conduct of members of the profession;
• hold members accountable to a high moral standard;
• demonstrate that the profession will act to protect the public interest;
• be specific and honest.
The code must go beyond basic societal sanctions against behaviors such as lying, cheating, and stealing. The code should address the temptations and potential pitfalls specific to the profession.
Members of a profession are in the best position to understand how a member might abuse information and power without public awareness of their activities. Only other members of the profession with a comparable knowledge base can restrain unprofessional or unethical conduct on the part of practitioners. A code of ethics should specifically regulate shady practices that, although they break no laws, are nevertheless unethical.
Finally, codes should make provisions to bring charges and to apply penalties in cases of illicit behavior. Codes must be enforceable and enforced. Society expects a professional association to demonstrate that it can and does police its own ranks. If an association fails to do so, society will not continue to grant the profession special privileges or a monopoly on information and power. Professions unwilling to police their own ranks force society to legislate or micromanage activities, much as it does professional occupations.
My next column will examine the code of ethics developed by the Case Management Society of America in light of the minimum requirements of the "implied contract."
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