Professional Autonomy and the Normative Structure of Medical Practice

Professional autonomy is often described as a claim of professionalsthat has to serve primarily their own interests. However, it can also beseen as an element of a professional ideal that can function as astandard for professional, i.e. medical practice. This normativeunderstanding of the medical profession and professional autonomy facesthree threats today. 1) Internal erosion of professional autonomy due toa lack of internal quality control by the medical profession; 2)the increasing upward pressure on health care expenses that calls for ahealth care policy that could imply limitations for the professionalautonomy of physicians; 3) a distorted understanding of theprofession as being based on a formal type of knowledge and relatedtechnology, in which other normative dimensions of medical practice areneglected and which frustrates meaningful communication betweenphysicians and patients. To answer these threats a normative structureanalysis of medical practice is presented, that indicates whichprinciples and norms are constitutive for medical practice. It isconcluded that professional autonomy, normatively understood, should bemaintained to avoid the lure of the technological imperative and toprotect patients against third parties' pressure to undertreatment.However, this professional autonomy can only be maintained if members ofthe profession subject their activities and decisions to a criticalevaluation by other members of the profession and by patients and ifthey continue to critically reflect on the values that regulate today'smedicine.     

Teaching business ethics to professional engineers

Without question “business ethics” is one of the hot topics of the day. Over the past months we have seen business after business charged with improper practices that violate commonly-accepted ethical norms. This has led to a loss of confidence in corporate management, and has had severe economic consequences. From many quarters business educators have heard the call to put more emphasis on ethical practices in their business courses and curricula. Engineering educators are also heeding this call, since the practice of engineering usually involves working for (or leading) a business and/or engaging in business transactions. In the summer of 2002, Auburn University’s Engineering Professional Development program made the decision to produce—based on the author’s Executive MBA course in Business Ethics—a distance-delivered continuing education program for professional engineers and surveyors. Participants across the USA now may use the course to satisfy continuing education requirements with respect to professional licensing and certification. This paper outlines the purpose and content of the course and describes its production, distribution, application, and evaluation. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

The morality of weapons research

I ask whether weapons research is ever justified. Weapons research is identified as the business of the engineer. It is argued that the engineer has responsibility for the uses to which the tools that he designs can be put, and that responsibility extends to the use of weapons. It is maintained that there are no inherently defensive weapons, and hence there is no such thing as ‘defensive’ weapons research. The issue then is what responsibilities as a professional the engineer has in regard to such research. An account is given to ground the injunction not to provide the means to harm as a duty for the engineers. This account is not, however, absolutist, and as such it allows justifiable exceptions. The answer to my question is thus not that weapons research is never justified but there must be a strong assurance that the results will only be used as a just means in a just cause.     

Future directions in engineering ethics research: microethics, macroethics and the role of professional societies

Three frames of reference for engineering ethics are discussed—individual, professional and social—which can be further broken down into “microethics” concerned with individuals and the internal relations of the engineering profession and “macroethics” referring to the collective social responsibility of the engineering profession and to societal decisions about technology. Few attempts have been made at integrating microethical and macroethical approaches to engineering ethics. The approach suggested here is to focus on the role of professional engineering societies in linking individual and professional ethics and in linking professional and social ethics. A research program is outlined using ethics support as an example of the former, and the issuance of position statements on product liability as an example of the latter. An earlier version of this paper was presented at the International Symposium on Technology and Society 2000 (ISTAS 2000), Rome, Italy, 7 September 2000. Joseph R. Herkert directs a dual-degree program in engineering and humanities/social sciences and is editor of Social, Ethical, and Policy Implications of Engineering (Wiley/IEEE Press).     

Towards a research programme for ethics and technology

In this editorial contribution, two issues relevant to the question, what should be at the top of the research agenda for ethics and technology, are identified and discussed. Firstly: can, and do, engineers make a difference to the degree to which technology leads to morally desirable outcomes? What role does professional autonomy play here, and what are its limits? And secondly, what should be the scope of engineers' responsibility; that is to say, on which issues are they, as engineers, morally obliged to reflect? The research agendas proposed by the authors contributing to this special section, implicitly, give different answers to these questions. We suggest that an explicit discussion of these issues would greatly help in constructing a common research agenda.     

The Emergence of Counseling in Sierra Leone

Sierra Leone has endured a turbulent history, including a decadelong civil war and the devastation of Ebola virus disease. Despite the psychological consequences of such events, only limited therapeutic services are available. The authors review mental health services in Sierra Leone and document the emergence of counseling as a profession in the face of challenges. They conclude by highlighting the multiple contributions that professional counselors can make to address critical mental health needs in Sierra Leone.     

Counselor Education Students’ Perceptions of Wellness and Mental Health in African American Men: The Effects of Colorism

Colorism is discrimination based on skin tone. Skin color influences clinicians’ diagnostic impressions. The degree to which colorism influences counseling students’ clinical decision making is unknown. This study examined colorism's effect on counselor education master's students’ (N = 154) clinical decisions. Analysis of covariance failed to produce statistically significant results when comparing students’ evaluations of a male African American's mental health and wellness, when controlling for presentation management, across 4 skin tones. Counselors should include colorism in diversity training. El colorismo es la discriminación basada en el tono de la piel. El tono de la piel influye en las impresiones diagnósticas de los profesionales clínicos. Se desconoce hasta qué punto el colorismo influye en las decisiones clínicas de los estudiantes de consejería. Este estudio examinó el efecto del colorismo en las decisiones clínicas de estudiantes de maestría en educación de consejeros (N = 154). El análisis de la covarianza no produjo resultados estadísticamente significativos al comparar las evaluaciones de los estudiantes sobre la salud mental y el bienestar de un cliente afroamericano varón, controlando la gestión de la presentación de 4 tonos de piel diferentes. Los consejeros deberían incluir el colorismo en la capacitación de diversidad.     

An overview of South African psychology

This overview of psychology in South Africa presents a concise and historical account of its science and practice, from its early origins in the late nineteenth century to the present, and traces seminal influences on the discipline. It is a review of how psychology in South Africa developed over more than a century to become one of the most popular subjects in universities and an established and recognized profession, whose members play a variety of roles in the South African polity and larger society. The impact that apartheid racism had on key aspects of psychology's development is traversed, and the influences that previous ruling party politics had on professional psychological organizations are delineated. The unification of psychology under the Psychological Society of South Africa, a few months before the advent of democracy in South Africa, is explicated. The protection of the title of psychologist in law and certain other changes in the legislative environment, enabling a greater role for psychologists, are reported. The primary research sites for psychology and its funding and the main university psychology programs are described, as are the requirements for registration and licensure. The genesis and the importance of the work of internationally acclaimed South African psychologists, such as J. Wolpe and A. A. Lazarus, are contextualized. With the increased participation of progressive black psychologists in leadership and research in the past two decades, a transformed psychology has the potential to play a significant role in addressing human issues confronting South Africa.     

Multicultural Personality Dispositions and Trait Emotional Intelligence: An Exploratory Study

ABSTRACT

This study examined the relationship between multicultural personality dispositions and trait emotional intelligence. The sample included 152 graduate education students enrolled at a university in a large northeastern city of the United States. The multicultural personality dispositions of Cultural Empathy and Social Initiative predicted variance in trait emotional intelligence above and beyond the variance accounted for by gender and potential socially desirable responding. Study limitations are highlighted, and suggestions for follow-up quantitative and qualitative research are presented.