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Letters to the Editor
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Professionalism
A narrowly scientific and rationalistic approach may obscure matters of ethics
From Ms A. Benson and others
Ian Caldwell’s article, “What
does it mean to be a member of a profession in 21st century Britain?” (PJ, 21 April, p461) mentions
the values that have been, and are, associated with the concept of professionalism.
Research to explore and map the values (and ethics) of the pharmacy profession
was funded, in 2002, by the Royal Pharmaceutical Society, through the Pharmacy
Practice Research Trust.1 There is an associated report.2 The research
identified two primary strands in the prevailing values of the pharmacy
profession — respect for medicines and the patient’s best interests.
There are some similarities with the characteristics that Mr Caldwell reported
from both the work of Watkins et al and the Royal Society of Arts report
of 2003.
Values linked to the respect for medicines strand include a strong attachment
to professional expertise, which leads to a conscientious approach to work
responsibilities, personal accountability, meticulousness, and acceptance
of the need for competence and skill. Those linked to the second strand,
the patient’s best interests, include relations with the patient
that are marked by values such as trust, integrity and fidelity and a tendency
to paternalism.
The dominant style of reasoning appeared to rely on a largely scientific
model of rationality, including the use of evidence in making assessments
of risks and benefits. The balance of risks and benefits is not the same
for all patients3 or necessarily for each pharmacist. Underlying such assessments
is the role of personal constructs and value judgements. Values (whether
personal, professional or that of the work place) frame the way risks and
benefits are understood, the options considered to be available for action,
and the justification for the decision taken.
There is much to commend the values identified through the research, but
two important issues emerge. The first is the potential danger that a narrowly
scientific and rationalistic approach may obscure matters of ethics. The
second danger is that a paternalistic emphasis on a patient and on personal
professional accountability may lead to an insufficient emphasis on responsibilities
to wider society.
To meet professional development opportunities, and changes in society,
the researchers suggests some further development of the respect for medicines
strand would be beneficial, and recommend a replacement second strand of
respect for people.
Ailsa Benson
Alan Cribb
Professor of Bioethics and Education
King’s College, London
Nick Barber
Professor of the Practice of Pharmacy, The School of Pharmacy, London
References
1. Benson A. Pharmacy Values and Ethics: A qualitative mapping of the
perceptions and experiences of UK pharmacy practitioners, in Centre for
Public Policy,
Department of Education and Professional Studies. London: King's College,
London University, 2006:255.
2. Benson A, Cribb A, Barber N. Respect for medicines and respect for
people: mapping pharmacist practitioners' perceptions and experiences
of ethics
and values. London: Royal Pharmaceutical Society of Great Britain, 2007:29.
3. Tallis R. Hippocratic oaths. London: Atlantic Books, 2004:342. |
The
Pharmaceutical Journal