Question to Ask the Prof:
Q: What are your ideas for keeping your personal and professional ethics separate? Consider the healthcare, there are a lot of issues (abortion, assisted suicide, euthanasia) when your personal ethics wont agree, but you have to work.
Answers from Professors Palanski and Barbato – who had an informative debate about the question!
Sometimes people are put in a situation of having to resolve a conflict between their personal ethics and other responsibilities. For instance, there are cases of pharmacists who refuse to fill a prescription for a morning-after pill, because they believe the pill would end a human life. However, the pharmacist is wrong. As a professional you are expected to fulfill your responsibilities as long as you are not breaking the law. Imagine what it would be like to live in a society where a judge convicts a woman of murder for having an abortion even though she broke no law. In this case the judge is imposing his o r her own law and violating his or her oath to uphold the laws of the land. Or imagine a doctor who allows a patient to die, because he or she believes the patient is a bad person and healing that patient would allow the patient to commit more crimes. Once again, the doctor is violating his or her professional oath to heal this person. If you cannot perform your professional duties without violating your own moral duties, then you should change your profession.
My colleague is very wise to suggest that one ought to consider with utmost care the professional duties that are associated with a particular job or profession, and to consider if these duties might conflict with one’s own value system. For example, if one values healthy eating and living, then a career in fast food might not be a good fit. This consideration is especially important in professions where one has a fiduciary duty to make decisions which are controversial or unpopular (such as law enforcement with a police officer or a judge).
However, I would argue that the distinction between public and private values is overblown, and that one’s ultimate allegiance should not necessarily be to one’s professional ethics, but to one’s understanding of the moral law (or, to use Greek phrasing, an understanding of the good). In the case of a pharmacist or other health care provider, one’s professional allegiance (driven by an understanding of the good) should be centered on helping others and, driven by the dictates of one’s conscience, if one believes that a particular course of action may harm others (for instance, by prescribing a morning-after pill or assisting in a suicide), then that person should follow his or her conscience. As long as that person is transparent and consistent about his or her beliefs (for example, the OB/GYN who refuses to perform abortions), then there need be no conflict of professional and private values.
I agree with my colleague that, when individuals must resolve conflicts between their professional obligations and their personal ones, that one’s professional obligations do not necessarily trump one’s personal moral obligations. I also agree that transparency is essential in resolving these conflicts, although we have to be careful here, since transparency alone will not always lead to a reasonable solution for a woman who has a prescription for a morning-after pill. However, I am reluctant to allow conscience to play too critical a role in resolving these conflicts. I prefer moral reasoning.
Conscience is a nice guard against temptation, but temptation has nothing to do with ethical dilemmas. When one is tempted to do something that he or she knows is wrong, then hopefully that person will have a strong conscience and he or she will resist temptation. But if we use our conscience as a guide to resolving moral dilemmas, then we are keeping company with the terrorists who attacked on 9/11, the men who stalked and murdered abortion doctors, and the individuals who blow up government buildings or shoot legislators. All were men of conscience who sacrificed much to follow their conscience. I wish they had chosen the restrained path of moral reasoning, because the world would have experienced less suffering.
Moral reasoning is principled but flexible, and it will yield more pragmatic and res trained solutions, as opposed to conscience which can be dogmatic. That is not to say that someone shouldn’t take a stand when their principles require them to, but the individual should be prepared to pay the cost of his or her principled stand, and not expect others to do so, and they should use moral reasoning to seek a solution that ensures that others don’t pay those costs. For instance, in the case of the pharmacist who has concluded that he or she cannot fill a prescription for a morning-after pill, it is not enough to simply reveal this, since that could impose a significant cost on the woman who is in need of the pill and can’t find a pharmacist who is willing to fill a prescription in time. The pharmacist in this case must make sure that there is someone available who is willing to fill that prescription which he or she refuses to fill. The same is true for the delivery person who delivers the pill, the stock person who puts it on t he shelf, and the cashier who rings up the sale. None of them are acting ethically if they refuse to perform the duties that are expected of them. And if you are not able to resolve the conflict between your principles and your professional obligations, then you must choose a different profession. This is what conscientious objectors do when they refuse to be drafted as soldiers. It would be wrong for them to become soldiers and then refuse to kill an enemy combatant because their conscience prevents it.
The goal of ethics is to help us lead a good life, and in today’s complex, interdependent world, we must be guided by ethical principles that lead to a well-ordered and just society if we are to lead a good life. When other moral principles put us in conflict with the needs of others, then we need to use moral reasoning to find reasonable solutions for resolving these con flicts, and if we take a principled stand, then we must find ways to pay the cost ourselves instead of imposing it on others. Gandhi, Martin Luther King, Rosa Parks, and others have provided useful guides for showing us how we can take a principled stand against society in an ethical way. Their protests were peaceful and they were able to create the tension that was needed to change society. Ethical reasoning, not conscience, will help us find the line that separates MLK from suicide bombers.
“Conscience. That stuff can drive you nuts.” – Marlon Brando in On the Waterfront
Perhaps I focused a bit too much on conscience in my earlier statement. I agree that it is best used as a tool or a warning system, but is not reliable in and of itself for determining right action or thought. Let me approach it another way:
Just because something is legal or just because something is the current standard in a professional code of ethics does not mean it is necessarily right or good. I agree that a practicing professional needs to be largely in line with the ethics that are particular to his/her profession, but I think that there can and should be reasonable accommodation for alternative viewpoints, particularly those which involve controversial issues (like abortion). In other words, one should be able to conscientiously object to parts of a particular code without fear of direct sanction or punishment. Thus, the pharmacist who refuses to prescribe a morning-after pill because doing so would violate his or her personal convictions should be able to do so without punishment. We apply such accommodation in many areas – military objectors, scheduling work or school for religious accommodation, or refusing childhood vaccinations for philosophical reasons.
Now, to circle back to the original question, my short answer is that I would not keep personal and professional ethics separate. My colleague has said (and I agree) that if there is substantial misalignment between one’s personal values and the values of a particular profession, then perhaps it is best to find another line of work. I also happen to believe that limited accommodation is sometimes necessary and useful.
Like most good debates between reasonable people, the positions start to converge. I think we are really close. I have no problem with the idea of accommodating the pharmacist; I just don’t think anyone is compelled to accommodate, since we are talking about a choice here. I certainly don’t think the patient should do the accommodating. If we are compelled to accommodate the pharmacist, then there will be a lot of accommodations to follow, including co-workers who won’t sell cigarettes, condoms, adult magazines, and candy for starters. The poor drug store owner will surely need an aspirin for all the headaches to come.
Which he won’t be able to get because the pharmacist believes in no pain, no gain.