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Know your ethical practices
The course has advocated neither a particular doctrine of ethics nor an exclusive approach to the subject. The diversity of the various methods and disciplines on which we draw and the range of the social and intellectual purposes we serve are too great to permit an orthodoxy to develop. Yet, as a result of our discussions and publications during these past two decades, it has become clear that there is a distinctive activity - what we have come to call practical ethics - that merits serious curricular and scholarly attention in the modern university, alongside the traditional disciplines in arts and sciences and in the professional schools. Three characteristics of practical ethics are significant.
First, practical ethics is a linking discipline, seeking to bridge theory and practice. But it differs from both applied ethics and professional ethics as they are usually understood. We remain as convinced as when we began that moral and political philosophy are essential disciplines for our work. At the same time, we now see more clearly that philosophical principles cannot be applied in any straightforward way to particular problems and policies. In the face of concrete dilemmas, we need to revise philosophical principles as much as we rely on them for justification. One reason is that principles often conflict: how, for example, should an attorney reconcile her commitment to a guilty client (a principle of loyalty) with her commitment to the truth (a principle of veracity)? Understanding such conflicts calls for critical analysis and elaboration of the principles, a process that is distinct from both deductive application and case-by-case intuition. We have also learned that moral reasoning as conventionally understood is not the only important element in deliberation about practical moral questions. Equally significant are moral perception - the ability to recognize an ethical issue in a complex set of circumstances - and moral character - the disposition to live ethically in a coherent way over time. A business executive, for example, may be disposed to act morally in his personal life, but may not see that moral issues are raised in his professional life when he decides to close a plant, or to accept the health risks of workplace hazards. To better understand these dimensions of moral life, practical ethics must draw on other disciplines and other forms of knowledge in addition to philosophy. Understanding ethical decisions in such professions as business, government, law, and medicine obviously requires knowledge of those professions, but beyond that it needs the assistance of moral psychology, sociology, economics and political science.
We have also become more critical of professional ethics as it has been taught in many professional schools. Practical ethics in the professions should consist of more than a study of the codes of ethics, such as the legal profession's code and model rules, or the emulation of role models, as in clinical rounds in teaching hospitals. These may be an important part of moral education in the professions, but if they are the principal part they reinforce parochial and technical conceptions of professional life. Practical ethics tries to relate professional rules and clinical experience to the broader social context in which professionals practice, and to the deeper moral assumptions on which professions depend.
Among the questions we have found significant are conflicts between duties of professional roles and those of general morality; conflicts within professional roles arising from competing understandings of the purposes of a profession; the duty of professionals to serve the public good; the legitimacy of professional authority; and the accountability of professionals. To address these kinds of questions, we have further sought to relate professional ethics to some of the larger questions prominent in recent philosophy such as the relativism of justice, the foundation of rights, and the limits of morality.
A second feature of practical ethics we have emphasized is its institutional context. Most people live most of their lives under the influence of institutions - schools, corporations, hospitals, media organizations - working for them or coping with them in one way or another. Yet ethics, both as an academic discipline and as concrete practice, has tended to focus either on relations among individuals, or on the structures of society as a whole. It has neglected that middle range of intermediate associations, of which institutions are the most durable and influential. Institutions are the site of many of our most difficult moral problems, as well as the source for many of our most promising solutions. We need to pay attention, for example, not just to the ethics of doctor-patient relations, or to the justice of health care policy, but also to what might be called hospital ethics. On what basis should hospitals allocate scarce beds in the intensive care unit? What rights should professionals and other employees have to dissent from a hospital's policy on, for example, AIDS precautions or physician-assisted suicide? To address such questions adequately, practical ethics must go beyond the moral principles of individual ethics, yet pay attention to the moral life that dwells among the structures of society.
Through the years, we have also recognized that many of the issues that professionals face go well beyond the practice of their profession. That is one reason we have devoted at least as much attention to more general ethical issues, such as the questions of war and peace, global justice, environmental responsibility, the problem of immigration, standards for political campaigns, and the role of religion in public life.
The third characteristic of practical ethics that has become increasingly important is its political nature. Practical ethics is political because it cannot avoid the question of authority: who should decide? The distinction between the right decision and the right to make the decision is especially significant in practical ethics because people reasonably disagree about many ethical issues - for example, abortion or capital punishment. Practical ethics has to provide principles for resolving, or at least accommodating, such disagreement. It is not simply a matter of choosing a particular procedure (majority rule, informed consent, shareholder proxies, and the like) to settle such disputes fairly but finally. We have found it more illuminating to think of the problem as involving a process of deliberation - continuing interaction in which the way the disputants relate to each other is as important as the question of who has the right to make the decision in the end. Practical ethics in the professions is also political in another, more familiar sense: it addresses the question of who should regulate the ethics of the professions. This question takes on new significance as the tension between the ideal of the self-regulating profession and the reality of market-oriented professionals becomes increasingly salient. We should be reluctant to abandon the ideal since it has traditionally expressed the principle of service to others, which is the ethical essence of a profession. But patients, clients, customers and citizens are legitimately seeking more control over the professions, sometimes through the market, and sometimes through politics and the law. Professional ethics, as many professionals themselves insist, is too important to all of us to be left only to professionals. The pressing challenge for the future is to forge, in principle and in practice, a union of the traditional idea of the autonomous profession (preserving its ethics of service) and the modern demand for accountability (acknowledging an ethics of responsibility). Beyond the professions, the challenge is to find the principles and practices that will enable all of us to acknowledge what we owe to one another in the public life that we inevitably share. The ethics of public life is too important to be left only to ethicists.