Institutional Turn in Professional Ethicsand

The Problem of Responsibility

Institutional Turn in Professional Ethics

• A recent development.

• Study of ethical issues that are more salient in institutions than in relations among individuals.

• Institutional turn becomes necessary because of the institutionalization of the professions.

Institutionalization of the Professions

• Shift from social trustee professionalism to expert professionalism.

• Social trustee professionalism: Professionals alone or in small groups serve their patients or clients in accord with a public-spirited goal.

• Expert professionalism: Professionals serve in organizations that value mainly their expertise and expect them to act in accord with the organization’s goals, which are often determined by the market and economic pressure.

The Healthcare Sector

• There are an estimated 14,000 hospitals in India, excluding the private clinics and nursing homes

• the corporatization of the healthcare sector

• Growth in the health insurance market

• Development of medical tourism

Similar situation in many other sectors

Institutionalization of the Professions:The Changing Global Scenario

In 1982 less than 1% of US hospitals had ethics committees

Now more than 90% of large hospitals have ethics committees

• Many scientific laboratories now train scientists in ethics

• Corporations are hiring ethics consultants• Ethics workshops to employees

Escalation of Ethical Scrutiny

• Our lives are increasingly affected by decision taken by others

• The dependence on professional bodies has rapidly increased

• The increase in the volume of stake-holders in professional services brings in more perspectives and more diversity

• Ethical differences become sharper and ethical scrutiny more salient

What is Required?

• More Tehelkas, more processions and prosecutions, more rules can never make substantial changes

• More direct response to the movement for greater accountability

• Understand and institutionally well define responsibility

• Institutional ethics

Institutional Ethics: A Different Paradigm

Deviation from a focus on individual vices: bribary, extortion, greed, personal gain, sexual misconduct

Focus on institutional vices: abuse of power, improper disclosure, excessive secrecy, lack of accountability

Vices

IndividualVices

Institutional Vices

Interrelated

Originates in face-to-face relations among individuals

Need to set standards for impersonal relations among people

Institutional Ethics and Individual Ethics

• Are different

• Share the common moral foundation

• Individual ethics aims to make individuals morally better

• Institutional ethics seeks to make institutions better by making their leaders more accountable

• Thompson,DennisF, Restoring Responsibility: Ethics In Government, Business And Healthcare, Cambridge, Cambridge University Press, 2005.

• Rollin, Bernard E, Science and Ethics,Cambridge Univ. press.2006

Who is Responsible?

When Gopal joined the department, Jairaj took him around to show how the distribution system works. He observed that while the acid distribution piping has spring –loaded valves that automatically close when not in use, the caustic valves have to be manually operated.

• Is Jairaj the only personal who is responsible? • Is Gopal responsible?• Who all share the responsibility?• What does responsibility mean?

Meaning of Responsibility

• Narrow down to one person or a group of people and punish them to deter others.

• Examine what factors and circumstances led to the undesirable situation, so that we can create awareness and bring improvement.

Malpractice Model

• Gopal was a disciplined professional. Does everything belong within his preview?

• But Gopal conforms to the standard operating procedures of his profession. Spring-loaded valves are costly. Moreover Jairaj’s job is to take care of such things.

• But he noticed that the caustic valves do not have spring –loaded valves and have to be manually operated. He could have got them changed.

• This is a very narrow view. It is minimalist and legalistic.

• Focus on malpractice

Malpractice Model

• This is the result of a view of responsibility which links the latter with blame.

• It looks for the person who has done it in order to blame him.

• It is based on the deterrent view of punishment.

• Gopal feels that he is also responsible.

• Though I am not expected to go around and check all the valves, I could have prevented it from happening.

• There may be a standard of reasonableness as seen by a normal, prudent non-professional that is more demanding than the mere minimalist professional standard.

Reasonable Care Model

• Explores what virtues or qualities of character professionals should have.

• What ought to be done without necessarily blaming or faulting.

• Responsibility is a virtue

• Positive view

• No focus on fault or blame.

• No link between responsibility and blame.

• Other-regarding

• Intrinsically motivational

• Binds persons together.

• Focus on common good.

Impediments to Responsibility

Self Interest• Failure to see beyond

our horizon. • Failure to see the

larger picture.

Self Deception• Do unto others as you

would have others do unto you.

• Confront yourselves honestly and ask if you would approve of others treating as in the same way as we treat them.

Impediments To Responsibility

Rationalization

• Everybody does it. So you have to do it in order to survive.

• In the name of ideology.

Weakness of Will

• No courage

• Give way to temptation

Impediments To Responsibility

Ego-Centric Thinking• Limited perspective• A special form of

ignorance – inability to understand things from other perspectives.

Ignorance• Of vital information. • Of the potential

danger of a design.

Microscopic Vision• Seing only one aspect• Over-importance to

one aspect.

Relevant Values

• Protect society from harm by using technology

• Follow basic human values: impartiality, honesty, reliability, honesty etc.

• Respect for life, freedom and human rights

• Treat others as end.

Relevant Values

• Do not make your opinion about which you do not have sufficient knowledge.

• Do not present somebody else’s views as your own.

• Credibility: of client, employer, society etc.

• Client confidentiality.

• You are a mechanical engineer working in a government enterprise. One private engineering firm has asked for your recommendation for one of their projects. But the project is in an area which you are not familiar with. You approach a colleague of yours and learn from him the details and submit your reco. Is it ethical?

• Do not make opinion public about issues which you do not have sufficient knowledge.

• Your organization plans for a modification in the design of a particular product and the management had sought opinions from all senior engineers. You discusses the issue with some of your project students and got ideas from them. You present them before the management and got them approved and subsequently got a promotion.

• Do not present somebody else’s view as yours.

• You located a major technical flaw in your company for which some of your colleagues are responsible. Some of them are seniors. They requested you to keep quiet as if you do not inform the management they will not be caught. They assure that they will be extra cautious in future. Some of the people involved are good friends and some of them are responsible for you getting this job.

• Clash of interests.• Credibility – towards your employer, client etc.