The Business Ethics of Bioethics Consulting

In examining the question, How can bioethicists consult ethically. I want to draw lessons from the field of business ethics. Not only does the business ethics literature offer concepts that shed light on issues of conflict of interest in a for-profit environment, but business ethicists inside and outside academe have consulted actively to corporations for over a decade and have learned from their experience. Leading consulting firms and many accounting firms maintain business ethics units, and academic business ethicists consult frequently to large corporations. Noting that money can sometimes taint consulting advice, bioethicists sometimes wonder whether they should accept pay for their services. When a bioethicist provides consulting services to a business reconsidering the health care insurance it offers employees, or to a pharmaceutical company wondering whether and how a product may be marketed, or to a biotechnology firm trying to determine the ethical constraints on its research agenda, does financial compensation taint their advice? From the perspective of those in business ethics, the notion that biomedical consultants should turn down money is silly. Most business ethicists accept the insight from neoclassical economics that the market functions as an allocation mechanism directing, however imperfectly, scarce resources toward human ends. The point is that a refusal by bioethics consultants to accept remuneration would frustrate the market's attempt to allocate resources toward important interests. Without remuneration, bioethicists would eventually either stop consulting or reduce the level of their consulting substantially. Of course, bioethicists are well advised to sometimes contribute their services to worthy causes on a pro bono basis, but the motive for doing so is charity, not professional duty. Business ethicists seldom if ever advise other professionals working within a market economy to refuse systematically to be paid for their efforts. To do so would weaken the social contribution of professionalism. Even priests and religious professionals are remunerated, although their remuneration frequently comes from institutional sources. Those in business ethics would argue, then, that the profit motive be tamed, not eliminated. For professionals, the answer is not to adopt a holier-than-thou stance but to avoid conflicts of interest while remaining true to the values of one's profession. The legal ethicist Michael Davis has argued that a person has a conflict of interest if (a) he is in a relationship of trust with another requiring him to exercise judgment in that other's service and (b) he has an interest tending to interfere with the proper exercise of that judgment. To this handy definition, one should add quickly that professionals are obliged to take a higher road than mere avoidance of conflict of interest. As I have argued elsewhere, a professional is someone who professes skills and knowledge derived from an ongoing institution dedicated to a that defines both expertise and service.[1] The broader good concept imposes the second of two critical conditions on bioethical consulting. Bioethicists must avoid conflicts of interest and remain true to their professions duty to serve the broader good. To be sure, identifying the professional broader good of bioethics consultants is difficult. Most bioethicists are also academics or persons with advanced academic degrees who maintain substantial research interests. To this extent they possess professional duties as scientists--that is, as seekers of knowledge. Yet because they are bioethicists--and not physicists, linguists, or historians--bioethics consultants sometimes are viewed as having professional duties to enhance health care. Lastly, to the extent that they function as consultants, bioethicists may be considered business professionals, and therefore obliged professionally to attend to the interests of their clients. …