Chapter19-EthicalIssuesCODESANDGUIDELINESColinL.SoskolneRangeofPurposesBehindCodesCodesofethicsintheprofessionsservenumerouspurposes.Attheleveloftheprofessionitself,codesdocumentthestandardsaccordingtowhichtheprofessioncanbeheldaccountablefortheconductofitsmembers.Further,becausesocietyrelegatescontrolformanyoftheprofessionstotheprofessionalorganizationsthemselves,theprofessionshavedevelopedcodestoprovidethebasisofself-regulation(Soskolne1989).Attheleveloftheindividualprofessional,codescanprovideapracticalguidetomembersoftheprofessionwhomightbeexperiencingamoralorethicaldilemmaconcerningtheirprofessionalconductinaparticularcircumstance.Whereaprofessionalfindshimselforherselfinastateofmoralorethicaltension,itisself-evidentthatcodescanbehelpfulinprovidingcounsel.Theexistenceofacodeprovidesthebasisofaprofession’sethicsprogrammeofactivitydesignedtoinstilethicalstandardsamongitsmembership(Gellermann,FrankelandLadenson1990;Hall1993).Revisionstothecodecanbeconsideredthroughgrass-rootsindividualmembershipinputatorganizationalmeetings,workshopsandconferences.Thisongoingdiscussionofissuesandconcernsconstitutesareviewprocessensuringthatanycoderemainssensitivetochangingsocialvalues.Professionsdependingfortheirsustenanceonpublicsupporttherebyimprovetheirlikelihoodofremainingpubliclyaccountableandrelevant(GlickandShamoo1993).Codescouldassistprofessionalsbeingchargedwithmalpracticeandperhapseveninlitigation.Demonstratedadherencetoone’sprofessionalcodewouldlikelybedeemedindicativeofadherencetostandardsofpracticeconsistentwithprofessionalnorms.Ifsuchpracticeweretohaveresultedinharm,thecode-abidingindividualprofessionalwouldbelesslikelytobefoundguiltyofhavingcommittedawrong.However,basedontheprincipleoftrust(Pellegrino,VeatchandLangan1991),thepublichastheexpectationthatthebestpossibleprofessionaljudgementwillbeexercisedinthepublicinterest.Wherethephysician-patientrelationshipisconcerned,thepatienthastherightundertheprincipleoftrusttoexpectthathisorherinterestswillbebestserved.However,anethicaltensionariseswhenthepublicgoodispotentiallyharmedincircumstanceswheretheindividualpatient’sbestinterestsarebeingserved.Insuchcircumstances,itisthepublicgoodthatwillusuallyneedtotakeprecedenceoverthatoftheindividual.Regardless,codesprovidenosubstituteforlegalliabilitydimensionsofconductforwhichgovernmenthasenactedlawstoprotectthepublicinterest(Cohen1982).WeightandIntentofCodesCodesdohaveassociatedwiththemthenotionofstatutoryforce,implyingtheabilityfortheirenforcementthroughtheadministeringofsometypeofdisciplinaryaction.Indeed,thenotionsofaccountabilityandself-regulationreferredtoabovehaveassociatedwiththemsomesenseofcontrol(minimally,peerpressure;maximally,theremovaloflicencetopractice)thatcanbeexercisedoverthemembersoftheprofessionbytheprofessionalorganizationitself.Becauseofthis,someprofessionalorganizationshavepreferredtoavoidtheseconnotationsassociatedwithcodesandoptratherfor“guidelines”.Thelatteremphasizeguidancewithfewerimplicationsforenforcementassociatedwiththem.Othergroupshavepreferredtoavoidallconnotationsassociatedwithcodesorguidelines;instead,theyhavepreferredtodevelop“declarationsonethics”fortheirspecificorganizations(Jowell1986).Throughoutthischapterthetermcodewillimply“guidelines”.Itshouldbeapparentthatcodes(andalsoguidelines)donotcarrytheforceoflaw.Inessence,codesandguideline...
优质VIP
