What
is professional integrity?
Andreas Eriksen
Centre for the Study of Professions, Oslo and Akershus
University College of Applied Sciences,
andreas.eriksen@hioa.no
What is professional integrity and what makes it so
important? Policies are designed to promote it and
decisions are justified in its name. This paper
identifies two competing conceptions of professional
integrity and argues that, on their own, both are
deficient. In response, this paper develops a third,
interpretive view, in which professional integrity is
conceived as the virtue of being good on the word of the
practice. Professions ask for the public’s trust and in
doing so, generate a set of legitimate expectations.
Judgments of professional integrity are informed by an
interpretation of practice that is sensitive to this
normative situation.
Keywords: professional integrity, virtue theory,
assurance, role interpretation, reasonable disagreement
Introduction
Integrity
is widely regarded as a key virtue for
professionals. Two main kinds of reasons are
commonly offered to explain the value assigned to
professional integrity. The first kind concerns fidelity to
the fundamental goals of the role. For example, the
appeal to professional integrity in cases of
conscientious objection in the medical context is
often described in terms of loyalty to
profession-specific ends, such as life and health.
The second kind of reason is assurance;
when issues of corruption and conflict of interest
are debated, professional integrity is often
emphasized as the virtue that gives us reason to
trust role holders to place professional standards
above self-interest.
In this paper, I will develop an account of
professional integrity as a distinct virtue (rather
than just “ordinary” integrity in a special context),
involving responsiveness to both fidelity and
assurance. This view will be developed in a loosely
Aristotelian way, as a response to two alternatives
that turn out to be professional vices, which can be
traced in the literature on professional integrity.
One of these views emphasizes fidelity to the ends of
a professional practice, as in health or education;
this may be called the teleological
view. The other alternative sees professional
integrity as a matter of assurance and conceptually
identical to ordinary integrity; this may be called
the generic
view. As a third alternative, I develop the interpretive
view. On this account, professional integrity is
distinct from ordinary integrity but not because of a
direct commitment to profession-specific ends. What
makes professional integrity distinct is the way in
which it calls for an interpretive judgment of what
the role requires.
The Teleological View
The
teleological view describes professional integrity
as a commitment to key ends of professional
practice, as in education or health. Dean Cocking
and Justin Oakley (2001) provide a clear example of
this approach: “For, characterising the goal of a
profession in terms of the substantive good it
undertakes to serve helps us better understand
appeals to a notion of professional integrity as a
reason for refusing to carry out certain requests
for patients or clients” (Cocking & Oakley 2001:
83). Their main example is active voluntary
euthanasia, which they claim “is to betray the goal
of serving health which fundamentally defines their
profession of medicine” (2001: 83). Even if it would
be best for the patient to grant his or her
autonomous request to be killed, doctors do not feel
they act on this request in their capacity as
doctors. In this way, the authors differentiate
between personal and professional integrity. Active
voluntary euthanasia may be compatible with personal
integrity, but it must be performed with the
“doctor’s hat off” (Cocking
& Oakley 2001: 83). Cocking and Oakley
refer with approval to an article by Franklin G.
Miller and Howard Brody (1995) that expresses
similar ideas but with an even stronger emphasis on
the conception of professional integrity as
concerned with profession-internal values: “The acts
of physicians of integrity must serve the proper
ends or goals of medicine, and they must be
ethically appropriate means to these ends in light
of the values and norms internal to the practice of
medicine” (Miller & Brody 1995: 11).
The insistence that professional integrity cannot be
reduced to bureaucratic rule- following or mere
responsiveness to client or patient requests is an
attractive feature of this approach. The
teleological view accepts rules and requests only
insofar as they are sanctioned by a legitimating
end. Oliver Wendell Holmes Sr., a physician renowned
for his literary skills as well as for reforming
medical practices of the day, elegantly elaborated
on the importance of this point, expressing only
disdain for “plain
practical workmen” who “go about the work of the
day before them, doing it according to the rules
of their craft, and asking no questions of the
past or of the future, or of the aim and end to
which their special labor is contributing” (Holmes
1860: 8). Holmes drew a striking analogy to one of
Sir William Edward Parry’s Arctic expeditions. The
expedition was supposed to be racing towards the
North Pole, but the ice they travelled on was
drifting towards the Equator, and this reverse
travel would remain undiscovered if everyone kept
their eyes strictly on the track they were
plodding. Holmes used this story to illustrate the
necessity of seeing practice in light of its
larger purpose: “It is not only going backward
that the plain practical workman is liable to, if
he will not look up and look around; he may go
forward to ends he little dreams of” (Holmes 1860:
8). Holmes’s dreaded “plain practical workman”
appears to be the opposite of an agent with
professional integrity. The Arctic parable
expresses the common understanding that
professional integrity is a virtue that demands
that role holders lift their gaze and allow their
judgments to be informed by a sense of purpose.
The virtuous alternative to the plain practical
workman is a role holder who makes responsible
judgments with a reach that extends beyond the
immediate task.
The teleological view would deny professional
integrity to role holders who are unwilling to
make evaluative judgments that reach beyond the
immediate task. A doctor of integrity will see his
actions in light of the overarching end of
promoting health and not simply as performing
assorted tasks without further connection.
However, Holmes asked role holders to “look up and
look around,” and the teleological view fails on
the “look around” part. The teleological view
requires role holders to be faithful to
profession-specific ends, but does not ask them to
integrate these ends with the wider array of
legitimate expectations.1
Miller and Brody are very explicit about this:
“Ethical considerations of respect for patient
autonomy, social utility, and justice lie outside
the domain of professional integrity, which
constitutes the internal morality of medicine” (Miller
& Brody 1995: 7; see also Lantos,
Matlock, & Wendler 2011: 495).
A figure inspired by the main character of the TV
show House
M.D. serves to illustrate how this view is
problematic. Let’s call him Greg, and ignore the
interpretive issues and various complexities in
the series. Greg has exceptional diagnostic skills
and a strong drive to solve medical puzzles.
Understanding the nature of an illness is what
matters to him, and he does not respect features
of practice that constrain the pursuit of this
end. According to Greg, procedural requirements,
organizational hierarchy, collegial norms, and
codes of ethics are more like annoying hurdles
than genuine sources of reasons to moderate
behavior.
Importantly, Greg’s transgressions do not seem to
be betrayals of a practice-internal good. That is,
his failings as a professional are not due to a
pursuit of goals foreign to the heart of medicine.
Greg is not acting in the name of self-interest,
nor is he pursuing money or fame. His disrespect
for what he considers mere conventions of practice
is a consequence of his sincere commitment to
providing correct treatment according to his own
judgment. Greg only violates norms regulating
patient autonomy or confidentiality when he
believes there is some medical gain.
Can defenders of the teleological view denounce
Greg without altering their conception of
professional integrity? That would seem to require
a special claim about how the virtue can be
possessed. Defenders of the teleological view
could bite the bullet and grant Greg professional
integrity despite his lack of other virtues. On
this reading, Greg is a raw manifestation of
professional integrity, purged of all kinds of
external side-constraints and independent of other
professional virtues. Certainly, this strategy
identifies a distinct character trait, but it
remains an open question as to whether this trait
is a virtue. Do we value such behavior in the role
holders we depend on? Advocates of this view might
admit that we would not want professionals to be
so anarchic and dismissive of shared norms but
counter that integrity is only one of many
virtues. At least Greg possesses this one virtue,
although it would be preferable if he also had
others, such as respectfulness and collegiality.
However, this pick-and-mix approach to virtues is
untenable. As McDowell (1998) puts it, “the
particular virtues are not a batch of independent
sensitivities” (McDowell 1998:
53). His example of kindness illustrates how full
possession of a virtue requires responsiveness to
the requirements of other virtues, such as
fairness. What elevates a disposition into a
virtue is that it is conducive to right action.
But the relevant behavior associated with kindness
will not always produce right action by itself.
Suppose, for instance, that one can express
kindness by being sensitive to Mary’s feelings and
granting her request for something. What then if
this request is granted at the expense of a (still
valid) promise one has made to Martin? McDowell’s
point is that the relevant range of behavior
associated with one virtue does not lead to right
action unless constrained by a sensitivity to
other considerations—like, as here, promissory
rights. In short, there is unity to virtue; true
kindness is not blind to justice.2
Similarly, dismissing institutional procedures and
widely accepted norms as misguided conventions is
not professional integrity but the vice of
arrogance. The unity of virtue requires us to
reject the claim that “respect for patient
autonomy, social utility, and justice lie outside
the domain of professional integrity” (Brody &
Miller 1995: 7). Insofar as such broad features of
medical ethics are genuine values, professional
integrity is not indifferent to them; rather, it
is integrated with them.
Is the notion of practice-specific goods simply a
red herring in addressing the question of
professional integrity? This seems exaggerated, as
the teleological view surely captures part of
what constitutes the virtue. It is especially
disastrous for the integrity of a professional to
judge and act irresponsibly with regard to goods
that the practice has asked to be trusted with.
Acting with integrity in the name of a practice
that has promised to promote health requires
special rectitude in such matters, and any
betrayal of this value poses a specific threat to
professional integrity. Furthermore, it seems
reasonable to claim that a physician may think as
a private individual that active voluntary
euthanasia is morally permissible while still
seeing it as a break with the requirements of
professional integrity. However, the teleological
view does not capture the nature of the judgments
that lead to such verdicts.
The Generic View
Let
us now consider the opposite view—that
professional integrity is not a special value
commitment that transcends patient or client
expectations but a virtue that gives us reason to
trust professionals in the same
way that ordinary integrity is a trait that
gives us reason to rely on the words of friends
and confidants. This view can be found in many
accounts of professional integrity;3 for present purposes, it
will be useful to discuss a recent version of
this view, developed by Greg Scherkoske in Integrity
and the Virtues of Reason (2013). This
account is especially rewarding because it
emphasizes aspects of integrity that are of
particular importance in the professional
context.
Scherkoske argues that integrity belongs to the
family of epistemic virtues, along with traits
like intelligence, thoroughness, and
open-mindedness. On his account, a commitment to
the enterprise of excellent judging constitutes
integrity (Scherkoske 2013:
88). Persons of integrity are willing and
competent to hold and act upon their considered
judgments. Unlike people who constantly question
their own decisions or backslide in the face of
social pressure, persons of integrity take their
judgments seriously and are resolute in the face
of temptation to waiver. They trust their own
convictions when appropriate and suspend their
decisions only in light of relevant reasons.
Central to this account is the idea of
connecting integrity to responsibility in
offering reasons to others. Agents of integrity
have an adequate understanding of their
epistemic position and of what kinds of judgment
this position entitles them to. They use this
understanding to constitute themselves as
authors of dependable assurances: “People of
integrity are constitutively good on
their word: that is, they are good sources
of competent and reliable reasons for action and
belief” (Scherkoske 2013: 150, italics in
original). In other words, persons of integrity
are careful when they assert, promise, or use
other perfomatives aimed at providing
deliberative assurance to the receiver. They
take the associated commitments seriously,
taking care not to vouch for claims that they
are not in a position to validate. In other
words, they invite others to rely on their
judgment only when it is responsible to do so.
Scherkoske’s conception offers more than a
phenomenological account of common perceptions
of integrity; it also vindicates
the idea that this is a genuine virtue—a
character trait of value. His account builds on
the plausible methodological assumption that
both descriptive and normative adequacy are
required in defending any conception of
integrity (Scherkoske 2013:
16–20). According to Scherkoske, giving an
account of integrity is not just about
structuring common understandings; it is also
about explaining why we are right to value
integrity. What makes integrity a virtue in its
own right is its importance in contexts where we
depend on others: “Integrity is distinctive
partly because of why we
want it in the persons whom we surround
ourselves with, specifically those mentors,
friends and advisors upon whose judgment we
rely” (Scherkoske 2013:
150, italics in original).
Professionals are perhaps the paradigm case of
persons whose word is offered as trustworthy. It
is constitutive of professional roles that they
aim at being good sources of reasons for belief
and action. As the sociologist Everett Hughes
formulates the “essence of the professional
idea,” professionals “profess to know better” (Hughes 1984:
375). Physicians purport to know what is good
for our health and offer their judgment as
something to be relied upon. Teachers invite us
to trust that they know how to educate our
children. Lawyers take on our cases with the
promise that their legal aid is dependable. In
short, professions are institutions that present
themselves as worthy of being entrusted with a
key social responsibility.
In this vein, Andrew Abbott’s influential
sociological account describes professions as
actively requesting the public to treat their
word as singularly trustworthy: “In claiming
jurisdiction, a profession asks society to
recognize its cognitive structure through
exclusive rights” (Abbott 1988:
59). The actual transactions may take many
forms, of course. As Abbott explains, “In
America it is ultimately through public opinion
that professions establish the power that
enables them to achieve legal protection. By
contrast, on the Continent the state itself has
traditionally been the professions’ public” (Abbott 1988:
60). The relevant point here is that being good
on one’s word as a professional involves a
responsiveness to public expectations engendered
by the claim for a socially recognized
jurisdiction.
On this reading, professional practice is
constituted by its assurance
relation to the public. This frames the
virtue of professional integrity within a
different conception of practice than that
suggested by the teleological view. In
particular, it is a deontic conception,
emphasizing practice as a source of demands, as
opposed to an axiological conception that
focuses on the internal values of the
profession. The general concept of professional
practice seems to allow for both readings.
Nevertheless, the deontic conception is more
appropriate for understanding the value of
professional integrity. Seeing professional
practice as constituted by an assurance given to
the public enables us to connect the virtue to
our legitimate expectations. As Scherkoske
argued, our reasons for seeking integrity in
others is an important aspect of what makes it a
distinct virtue. Given that the public entrusts
professions with key social responsibilities, it
is therefore reasonable to connect the virtue to
the assurance relation that has been created.
So far, there has been little reason to doubt
the generic view, to which Scherkoske’s account
is explicitly committed. He claims that
distinctions commonly made between types of
integrity serve only to “make clear the content
of the relevant set of convictions, in the
adherence to which a person expresses her
integrity” (Scherkoske 2013:
101). That would imply that there are no
interesting or substantive differences at the
conceptual level, and this claim is not without
plausibility, as Scherkoske has made a strong
case that integrity is a matter of responsible
assurance. Moreover, it has been argued that the
notion of assurance is partly definitional of
the professions. In other words, professionals
are bound by the mechanisms of responsibility
that Scherkoske has referred to in explaining
integrity.
However, this view should also be considered in
relation to Greg. Again, Greg only cares about
getting the diagnosis right; routines, codes and
norms are to be conformed to only insofar as
they are instrumental in solving the case at
hand. Although Greg fails to live up to the
standard image of a doctor, he exhibits much of
what we associate with ordinary integrity.4
He sticks to his best judgment and ignores what
he thinks are misguided conventions. He has the
courage to put conviction over desire for
approval, and he has the strength to hold and
act upon his considered judgments. Certainly, he
may deceive his patients and colleagues in order
to find the key to a particular medical mystery.
However, he is generally candid about his
overall approach, and he is not afraid to state
his actual reasons for action. He is an
integrated agent in the sense that his mind is
made up on matters of importance, and he speaks
his mind when questioned. But is this sufficient
to meet the standard of professional integrity?
Defenders of the generic view hold that the
ordinary virtue of integrity is sufficient to
secure an appropriate responsiveness to
role-dependent expectations. However, if that
were so, we should ascribe professional
integrity to anyone who maintains personal
integrity in the work context. The case of Greg
illustrates how this creates an internal
conflict in the generic view, because it runs
counter to Scherkoske’s own requirement of
normative adequacy. As he claims above,
integrity is distinct largely because of why we
want it in people we rely on. His conception of
ordinary integrity seems plausible partly
because it vindicates our sense that it is
valuable. But this normative condition of
conceptual distinctness actually points towards
a divide between ordinary and professional
integrity. We value professional integrity in
role holders largely because it prevents them
from acting like Greg. As patients or clients,
we encounter professionals as representatives of
practices with standards that are supposed to
warrant our trust. Whatever one may think of
Greg as an illustration of ordinary integrity,
he is not good on his word as a
professional. He does not take his
practice seriously as a shared enterprise with
common principles but sees his role as guided
solely by his personal judgment.
Evidently, Greg’s opinions on the authority of
various norms of professional ethics are
likely to diverge significantly from the views
of the people who depend on him. This means
that the generic view fails according to its
own standard; in holding professional
integrity to be essentially the same virtue as
ordinary integrity, the connection with
warranted assurance is lost. That is because
the reasons for wanting integrity in persons qua
persons differ from the reasons for wanting
integrity in role holders qua
role holders. When a friend offers advice on
how I should deal with a conflict, integrity
requires her to state herself
as the source of reasons. I value my friend’s
integrity as excellence in standing for her
own beliefs rather than merely paying lip
service to what I might approve of (cf.
Calhoun 1995). She remains an integrated
person by giving her word in a manner that
reflects genuine conviction.
Scherkoske would presumably agree that the
value of professional integrity does not refer
to personal conviction in this straightforward
sense. As already mentioned, his own notion of
warranted assurance would disqualify Greg from
being good on the word of his practice.
Nevertheless, the generic view fails to give
us an account of what Greg should be doing
instead. What we need is an account that
describes a mode of practical reasoning that
can live up to this standard. As discussed in
relation to the entrusted nature of
professional practice, the standard of
assurance that Scherkoske associates with
integrity has definite appeal in the
professional context. For the remainder of
this paper, I will defend the claim that
integrity as responsibility to be good on
one’s word takes on a distinct form in the
professional context. Professional agents hold
roles that purport to be trustworthy in light
of their public standards, and this implies a
break with the view that integrity is generic.
The Interpretive View
The
central
claim of the interpretive view is that for
professional integrity to connect with
assurance it must be an interpretive
virtue. I develop this view by following the
lead provided by Andrew Edgar and Stephen
Pattison (2011). They characterize
professional integrity as a mode of
reasoning that calls for the role holder to
engage critically and creatively with the
varied and sometimes conflicting demands of
practice. They describe the virtue as both
an “interpretive stance” and a “deliberative
capacity and competence which is deployed in
the context of complex professional and
organizational work to find appropriate
answers and ways forward” (Edgar
& Pattison 2011:
103). Daniel E. Wueste (2014) emphasizes
something similar in his discussion of
cheating and the duty to report it within
academic institutions; integrity requires
recognition that ethical decisions are
“situated” in a “cluster of relationships
that enriches but also, inevitably, makes
things complicated rather than simple” (Wueste
2014:
20).
These approaches indicate a conception of
professional integrity in which interpretive
and evaluative engagement with practice is
central. In developing the interpretive
view, I will connect the notions of being
“situated” and taking an “interpretive
stance” more systematically to professional
integrity. First, what is the fundamental
normative relation that governs the
situation? It is a promissory relation,
where the profession has given its word to
the public. Role holders are situated as
promisors. What is the object of
interpretation? It is professional practice
as a framework for decision-making. The main
idea is that for professionals to be good on
the word of their practice, they must act on
a defensible interpretation of what their
practice has promised.
The first step is to give Greg the proper
moral diagnosis, and it has been argued here
that the two preceding views could not do
so. His main failure is not a betrayal of
health, the key good of his practice. Nor is
it a lack of willingness or competence to
stand behind his considered judgments.
Rather, he lacks professional integrity
because he does not act in the name of his
practice. Formal requirements, codes of
ethics, institutional hierarchies, and
collegial norms are among the features of
professional practice that engender public
expectations of professional role holders.
For example, Greg’s medical practice is
subject to norms regarding respectful
consultation and patient autonomy. Greg does
not acknowledge the authority of these
standards, which means that the word of the
practice does not have the normative force
to override his personal judgment.
Evidently, the alternative to Greg cannot
simply be Holmes’s dreaded “plain practical
workman,” who simply acts on the most
straightforward and literal reading of role
requirements. As already mentioned,
professional integrity is often associated
with a refusal to carry out certain role
requirements (e.g. abortion and euthanasia).
We do not wish to entrust key social goods
such as health, education, and legal justice
to role holders who surrender their ethical
judgment in executing their role. In
developing the interpretive view here, the
goal is to provide an alternative to both
Greg and the practical workman, both of whom
fail to achieve an integrated understanding
of the practice they represent. Greg does
not integrate his sense of professional
purpose with the existing features of
practice. The practical workman, on the
other hand, does not integrate his
interpretation of practice with a sense of
purpose. It is time to introduce a third
character.
In articulating the interpretive view, it
will be helpful to borrow the figure of a
“chain novelist” from the theory of
adjudication developed by Ronald Dworkin. He
compares the task of judges to the task of
authors engaged in a “chain novel” (Dworkin
1985:
158–162; 1986: 228–238). This comparison
elicits a mode of reasoning that has general
relevance in the professions. A chain novel
is written one chapter at a time, and each
finished chapter is passed along to a new
author, who writes the next one. The task of
each author is to make this the best novel
it can be. It must unfold as a coherent
story rather than as a mishmash of different
visions. This calls for an integrated view
of the story elements. The chain novelist
“must take up some view about the novel in
progress, some working theory about its
characters, plot genre, theme, and point, in
order to decide what counts as continuing
and not as beginning anew” (Dworkin
1986:
230). According to Dworkin, this analogy is
apt both to describe and to justify the
actions of judges, who know that they are
deciding disputes in the name of a practice
that has given principled verdicts in
similar cases. The good judge views earlier
decisions “as part of a long story he must
interpret and then continue, according to
his own judgment of how to make the
developing story as good as it can be” (Dworkin
1986:
239).
Why suppose that the figure of a chain
novelist has relevance for professional
integrity? Judges are continuing the “story”
of law in a readily comprehensible sense,
but their standard for decision-making is
not obviously applicable to professional
roles in general. In order to see the
relevance of the chain novelist, we must
consider why the analogy was introduced in
the first place. The theory of legal
adjudication is a response to the fact that
judges have to decide “hard cases” that
cannot be read straight off the books. How
statutes should be applied or precedent
invoked is usually open to argument when
cases reach court. Judges must rule in favor
of a particular reading of the law; the
question is what makes one reading better
than another. The key end of legal practice
is justice, so one might suppose that
decisions are better or worse according to
the standard of justice. That is, good legal
decisions aim for outcomes that conform to a
vision of what is morally due to those
involved. This sort of answer would suit
Greg, if he were a judge. It fits his mode
of operation, which is to focus directly on
the key end of his profession. However, it
would also reintroduce the problems we
encountered above. What counts as a just
outcome is open to considerable
disagreement, and the direct application of
justice therefore places too much
responsibility on the role holder while
failing to explain the authority of the
decision.
Dworkin’s standard for adjudication involves
justice, but not as a direct measure of the
quality of legal decisions. As he
emphasizes, there is no “license for each
judge to find in doctrinal history whatever
he thinks should have been there” (Dworkin,
1985: 160). His figure of the chain novelist
is opposed to the idea that judges should be
guided directly by their perception of moral
desert. Rather, their role is to reach an
integrated view, where justice is draped “in
workclothes,” as one commentator has put it
(Postema 1997). That is, judgments are
informed by a conception of justice contained
within the grounds of existing law.
This conception is likely to be imperfect by
the judge’s own lights, just as a chain
novelist will be disappointed with certain
story developments. Nevertheless, neither
role holder is entitled to start with a
blank slate or make decisions untainted by
compromise.
This barely scratches the surface of
Dworkin’s complex theory of legal
adjudication, but it helps to show how the
chain novelist represents a mode of
reasoning that distinguishes professional
integrity. Unlike being good on one’s word
as an ordinary agent, the professional agent
represents a practice that has engendered a
multifarious set of legitimate expectations.
Professionals face the interpretive
challenge of trying to understand how such
provisions as codes, organizational
procedures, and norms constitute the word of
the profession. Like the chain novelist,
they must make their decisions in light of
an understanding of what others have done,
why they have done it, and what this
entitles the public to expect. The next two
sections will elaborate this idea by
defending it against two objections.
Why Interpret?
The
first objection concerns the need for
interpretation. One can accept Dworkin’s model of
legal adjudication and still deny that it captures
anything essential about professional integrity. Is
interpretive judgment a distinct and essential
aspect of professional integrity? One reason to
doubt the relevance of the chain novelist is that
the case of judges is idiosyncratic, as they must
make decisions that are inherently tied to
interpretive disputes. Judges are in court in the
first place because of disagreements over legal
decisions, which means their integrity is obviously
dependent on responsibility in interpretation.
However, the idea here is not that every
professional role involves interpretive tasks on a
par with adjudication. It is difficult to see, for
instance, how the interpretations made during
surgery are similar in any relevant way to legal
interpretation. Instead, the claim is that all
professional roles are executed in the name of a practice,
and that the word of the practice requires
interpretation precisely because the practical
import of the assurance relation is open to
reasonable disagreement. Nevertheless, even this
claim may seem suspect. One could claim that the
mission of the classic professional roles is settled
and that no fundamental disputes remain—that is,
that professional practice does not require an
interpretive stance.
To find an illustrative case for this objection, we
need look no further than the role of legal
representatives. The role of lawyers is supposedly
to defend the interests of their clients by means of
the various instruments available to them through
the legal system. A good lawyer will “without fear
defend the interests of his client and without
regard to any unpleasant consequences for himself or
to any other person” (International Code of Ethics,
1956/1964, 6.6). Lawyers owe loyalty only to their
clients, and their mission is to secure every
possible advantage obtainable through the legal
system. For example, they may use delaying tactics
in order to make it too costly for the opponent to
proceed, or instigate countersuits merely to create
conflicts of interest. In short, they offer their
skills to the client without any concern for legal
deserts. The adversarial system will in itself
realize legal justice; lawyers need not be directly
concerned with this end. Why, then, should
interpretive judgments matter here?
This objection is misguided in a sense that helps to
clarify the point of the interpretive view. Anyone
who held this view of the lawyer’s role would be
offering a deeply evaluative understanding of the
notion of zealous representation. In Tim Dare’s
terminology, they would interpret the lawyer role as
committed to “hyper-zeal” instead of “mere-zeal” (Dare
2009: 76–86). Hyper-zeal is concerned merely
with the interests of clients. This attitude
recommends using tricks of the trade to secure every
possible advantage obtainable with legal
instruments. Mere-zeal, on the other hand, is about
achieving the proper legal deserts for clients. The
goal is to secure legal entitlements
rather than interests as such. Dare delivers a
forceful defense of mere-zeal as the proper
understanding of zealous representation. In doing
this, he is taking a normative stand on what it
means to be good on the word of the practice. The
point here is not to argue in favor of the notion of
mere-zeal but rather to emphasize the disputed
nature of the ends of professional practice. As
noted by another author, Dare’s interpretation
“strikes some lawyers as deeply confused” (Wendel
2010: 79).
The ends of medical practice are no less disputed.
The previously mentioned claim by Cocking and Oakley
that active voluntary euthanasia involves a betrayal
of the key good of medicine aimed in part to explain
how health as an end distinguishes medical
professional integrity. However, in referring to the
article by Miller and Brody (1995), they
inadvertently reveal how professional integrity is
bound up with interpretive judgment of the role.
Brody and Miller do not tie medical integrity to the
pursuit of health in any straightforward sense.
Instead, they state three fundamental goals for the
practice of medicine: healing, promoting health, and
helping patients to a peaceful and dignified death (Miller
& Brody 1995: 11). These diverging
views on the nature of medicine lead to different
framings of particular decisions. Those who reject
the act of helping patients to a peaceful and
dignified death as a fundamental goal of medicine
are also likely to reject institutional procedures
and requirements for euthanasia as legitimate parts
of practice. For these role holders, their
understanding of medicine does not extend to helping
patients to a dignified death. Insofar as they
conform to institutional regulations connected to
euthanasia, they consider this to be external to
their true practice.
Many accounts of professional integrity emphasize
the complexity of cases and the conflicting
expectations that professionals encounter. The above
examples from law and medicine indicate how
responsible resolution of such complexity and
conflict builds on an interpretation of the word of
the practice. The normative force of client and
patient requests depends on what role holders
understand their role to be. Am I the mouthpiece of
my client? Does my practice involve helping patients
to a dignified death? Professionals of integrity
reason responsibly about such questions. They see
themselves as part of a practice that has offered
its word to the public, and they recognize their
responsibility to achieve clarity about what this
means. In this regard, the notion of interpretation
as highlighted by the figure of the chain novelist
expresses a distinct and important dimension of
professional integrity.
Why
Respect Flawed Decisions?
The second objection to the interpretive view
concerns the connection between professional
integrity and features of practice that are judged
by the role holder to be misguided or inadequate.
The interpretive view requires role holders to
continue the story they are part of, even when it
rests on decisions that one disagrees with. For
example, professionals of integrity comply with
established norms of patient autonomy even when they
believe that patients would be better off in a more
paternalistic institution. Neither the teleological
view nor the generic view offers any reason to think
that role holders of integrity should comply with
flawed decisions. However, one might counter that
this is a strength of these views, and that
professional integrity is antithetical to
compromise. In rejecting Greg as a model of
professional integrity, are we not disconnecting
this virtue from the notion of morally responsible
judgment?
This objection gains momentum from the plausible
constraint that Gabriele Taylor places on
integrity’s deliberative point of view: “The person
of integrity will not repeatedly act against her
evaluations” (Taylor 1985: 119). Any account of
professional integrity lacks credibility if it
denies that actions should be responsive to one’s
best judgment. How does this reflect on the figure
of the chain novelist, who complies with flawed
decisions? Unlike Greg, who always acts according to
his own vision, the good chain novelist continues
the story in ways that cohere with the preceding
installments. So, is the interpretive view more
interested in coherence than in getting it right?
This objection rests on a misleading distinction
between aiming for coherence and acting on one’s
best judgment. It fails to acknowledge that the
relevant coherence is a matter of fidelity to the
assurance given to the public. Professionals of
integrity are good on the word of their practice,
which requires integration of the various features
of practice into a coherent response to legitimate
expectations. While this may involve integrating
flawed decisions, it is not a call for a surrender
of judgment or action against one’s own evaluations.
On the contrary, professionals of integrity act
according to their best reading of practice.
Moreover, their interpretation proceeds on the
background condition that the practice is a
justifiable social institution. As such, it holds
authority for the role holder as a legitimate
framework for action in circumstances of reasonable
disagreement on how to realize values such as health
promotion, legal justice, or education provision.
There is no contrast between integrity and moral
judgment here because the legitimate role is
constituted by a binding social agreement on what
counts as legitimate grounds for professional
action.
Compare this with Kant’s (2009) conception of the
use of reason in entrusted offices. He describes the
clergyman who disagrees with the doctrines of the
church. As he notes, this priest is acting in
“someone else’s name” and will therefore expound the
teachings of the church in the entrusted manner.
However, Kant emphasizes that misguided features of
his practice are not simply executed without
interpretive judgment:
He
then extracts as much practical value as
possible for his congregation from precepts
to which he would not himself subscribe with
full conviction, but which he can
nevertheless undertake to expound since it
is not in fact wholly impossible that they
may contain truth (Kant
2009: 5).
This
remark
is interesting because it identifies two tasks for
evaluative judgment. First, the features of
practice that form the material for interpretation
must be reasonable or legitimate. This coheres
with the account of integrity defended above.
Professionals of integrity do not integrate
illegitimate aspects of practice into their
understanding of the role. For example, priests
are divided on the issue of gay marriage. Priests
who believe that it is sinful to
carry out such ceremonies are prevented by their
professional integrity to do so. Other priests may
hold that the directives rest on a reasonable
conception of core religious values, even though
they would not themselves recommend
the institutionalization of gay marriage. The
latter group is not prevented by their
professional integrity to carry out the ceremony.
In Kant’s words, role holders of integrity comply
with directives when it is not “wholly impossible
that they may contain truth.”
The second task of evaluative judgment mentioned
by Kant is to “extract as much practical value as
possible” from the given materials of the role.
This task is constructive, and the interpretive
view emphasizes that it must be guided by a sense
of professional purpose. The figure of the chain
novelist represents
a
particular mode of extracting value in light of
professional purpose. Like chain novelists,
professionals of integrity join the narrative of a
story that is partially developed but not
predetermined. The challenge is to continue the
story in a way that realizes its best potential.
Ideally, judgments made in the name of
professional practice draw on grounds that affirm
the assurance relation to the public. These
judgments are informed by existing rules and
procedures in a way that realizes the word given
to the public.
Conclusion
The
interpretive view explains professional
integrity as a virtue concerned with both
fidelity to practice and assurance to the
public, connecting these features by emphasizing
the role of evaluative judgment. In being good
on the word of their practice, professionals of
integrity are responsive to the entrusted nature
of their responsibility. From various sources of
legitimate expectations, they extract the most
compelling vision of how to realize the ends of
their profession. Like chain novelists who must
continue a partly written story, they recognize
the normative force of even the flawed features
of practice and integrate them into their
conception of the role.
However, good chain novelists recognize when the
story has gone astray and are obligated to bring
it back on track. In this regard, the
interpretive view highlights how objections in
the name of professional integrity deliver a
distinct verdict. Requirements that conflict
with professional integrity are not merely wrong
or misguided; they represent a break with the
word of the practice. The force of such a
verdict is obscured when integrity is
interpreted as loyalty to an “internal”
morality, narrowly concerned with
profession-specific ends. That conception
reduces professional integrity to a matter of
preserving the domestic purity of practice. The
true merit of the virtue lies elsewhere. Its
importance is explained by the aim of making our
trust in role holders warranted. Objections that
appeal to professional integrity address the
public as promisee. The justificatory weight of
such appeals depends on whether the alleged
break is supported by a responsible reading of
practice.
Acknowledgments
The
article has benefited from comments by
Anders Molander, Edmund Henden, and members
of the GPPS group at Centre for the Study of
Professions. I am also grateful to Morten
Magelssen for the opportunity to present an
early version at the Centre for Medical
Ethics.
Notes
1 In this
regard, we can distinguish between a wide and
narrow reading of the teleological view. On the
wide reading, the profession-specific good that
professional integrity is concerned with
includes considerations of justice, patient
autonomy, etc. It is possible to argue that
Cocking and Oakley belong in this wide category
because of two features of their account: first,
their inclusion of “side constraints” that
regulate the means to pursue the internal goals
of practice; second, their slightly
paradoxically formulated idea that health as the
proper goal of medicine is more than health (Cocking
& Oakley 2001:
90–92). However, the wide reading leads to
further questions concerning how integrity is
conceived as a unified virtue when tied to a
wider array of considerations. It is, at best,
the beginnings of an account of professional
integrity.
2 I am only
committed to what Gary Watson (1984) calls the
“weak unity thesis,” which says that in order to
have one virtue you must be sensitive to
considerations relevant to the others. McDowell
endorses the stronger claim that “no one virtue
can be fully possessed except by a possessor of
all of them” (McDowell 1998: 53).
3 Cox, La Caze
and Levine (2003, p. 103) attribute the generic
view to Benjamin (1990, chs. 3 and 6), Calhoun
(1995), Grant (1997), and Halfon (1989). To some
extent, this attribution rests on implicit
assumptions in the texts. Cox, La Caze and
Levine provide a brief critical discussion of
the view in general terms, but as Pritchard
(2006: 67–68) has argued, their own alternative
goes too far in the other direction, as they
make professional integrity a distinct virtue
for every individual profession.
4 Greg’s
disregard for general moral considerations does
not disqualify him from being an agent of
integrity on Scherkoske’s account, in which the
connection between integrity and moral
conviction is allegedly “frequent but
contingent” (Scherkoske
2013:
63). Scherkoske claims that standards of
ordinary integrity can be understood in a
non-moral sense. On his account, failure to be
good on one’s word is an “abuse of the
illocutionary norms and commitments internal to
assurance” (Scherkoske
2013: 179); so, lack of
integrity amounts to abuse of perfomatives like
promising or assertion, but supposedly, this
does not necessarily involve moral standards.
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