The Importance of Being Ethical

THE IMPORTANCE OF BEING ETHICAL CARLETON B. CHAPMAN* My title, chosen with apologies to Oscar Wilde, needs modest explanation. For one thing, the adjective "ethical" means many things to many people. There would be no confusion at all if my title had been "The Importance of Being Law Abiding. " Everyone understands that it is important to be law abiding in order to avoid punishment or penalty. It is also generally understood that the antithesis of law and order is social chaos, something no sane person desires. Ethics, however, is distinct from law. It is a permissible generalization to say that ethics is concerned with aspects of human conduct that lie beyond the concern of law, and that ethics is concerned ". . . not so much with what human conduct is, as with what it ought to be" 1, s. v. "ethics". From a practical point of view, the man in the street, our ordinary citizen, need concern himself almost entirely with the requirements of the law and will come to no great harm if he doesjust that. Ethics in the sense that it relates to ideal conduct is, on the other hand, no more than a theoretical entity to those relatively few men in the street who give it any thought at all. I shall not, however, be saying very much about the man in the street. On the contrary, I shall try to convince you that there are certain critical groups in American society to whom ethical conduct by realistic definition is an urgent necessity, whether or not those groups show by their actions that they realize it. Indeed, their very social and economic welfares depend, in the long range, on group and individual conduct that is above and beyond the minimal requirements of the law. But far more important than that: The survival of our nation as an open society, a coherent social and political unit within which basic individual rights and needs are still respected, also depends very meaningfully on those critiPresented at the Distinguished Lecture Series, University of Louisville, Louisville, Kentucky, October 17, 1979, at which time the author was president of the Commonwealth Fund, New York. "¦Professor and chairman, Department of Medical History, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461. © 1981 by The University of Chicago. 0031-5982/81/2403-022101. 00 422 I Carleton B. Chapman ¦ Importance ofBeingEthical cal groups. They are the nation's true professionals, and if they cannot be brought to comprehend their ethical obligation, as professionals, to American society, we shall have taken a giant step toward the totalitarian condition in which the only ethical obligation is to the state itself. But all this anticipates my conclusions. The Critical Professions Who, more specifically, are the nation's critical professional groups? There are many callings that refer to themselves as professions, but few of them really belong in that category, and their reasons for calling themselves professions are blatantly self-serving. They see some of the classical professions as respected and economically favored bodies and, not unnaturally, seek comparable status for themselves. But they fail to comprehend that there is more to it than economic and social advantage. The only valid social definition of a profession is in the form of a covenant: Society grants to certain specially competent groups distinct social and economic privileges in exchange for which those groups commit themselves to observe a professional ethic that focuses squarely on the interests of those whom they serve 2, p. 65. 1 When, for example, you consult a doctor, you as a layman are in no position to judge the adequacy of his training or his professional competence. You rely on licensure laws and, to a lesser extent, on the rules and practices of professional societies to protect you from professional inadequacy. But you also have expectations of him, as a professional, that go beyond all this: You expect him to do everything in his power to get you well. In brief, you expect him, within the professional relationship, to place your interests, your welfare, and your legitimate rights above all other considerations. Put in another way, you expect him to render professional services to. . .