Chapter Goals

• Identify the major professions
• Identify the basic features of the professions
• Understand why most occupations are not professions
• Distinguish between customers and clients
• Understand the role of professional organizations
• Understand the functions of licensure

1.1 The professions are distinctive

Some skilled jobs are called professions, and this special label indicates that they are more than merely jobs. The professions involve a special set of services to society, and people who join these professions are expected to uphold high ethical standards in their professional conduct.

Although many professionals have their own private businesses, and many others are employed by businesses, these occupations are misunderstood if we equate them with businesses. In fact, the growing tendency to treat professional work as nothing more than a paid jobs is the source of many ethical challenges.

• The primary goal of a business is to make a profit for the owners, and it does this by providing some product or service to customers.
• The basic purpose of a profession is to provide a service to the community. Here, the primary goal is societal well-being, not profit.

This distinction reflects a higher level of responsibility, expertise, and commitment to maintaining standards that sets professions apart from other occupations. Consequently, professional ethics should not be confused with business ethics. Although the business and corporate worlds frequently talk about “professional standards,” professional ethics prioritizes social welfare and the public good over all other goals. This pledge to serve the public good distinguishes professional ethics from business ethics. (A quick disclaimer: this not the narrow economic meaning of “public good,” which restricts it to something that has an inexhaustible supply. The meaning here is related to the notion that health services are a public good, as something essential to a stable and flourishing society that can only be provided by coordinated effort.)

Each of the major professions makes a public statement that lays out their commitment to societal well-being and to specific ethical standards that members of the profession pledge to uphold. Some professions are represented by several professional organizations, but upon examination one will find that their formal codes of ethics are very similar.

However, this book is not about the professional codes of the individual professions. Those codes are sometimes discussed, but the purpose of this book is to outline the ethical standards that apply across the board, that is, that apply to every profession. There are two levels to explore:

• On a personal level, there are ethical standards for individuals who are professionals
• On a collective level, the profession has ethical obligations that can only be carried out by the group working collectively.

Before going forward, a point must be made about basic terminology. Some people think that there is a distinction to be made between “morals” and “ethics.” In fact, the reason we have two words is simply that English draws words from many languages, and “ethics” is the ancient Greek word for the proper way to live.  “Morals” comes from Latin, and it is their corresponding word for the same idea. In keeping with standard practice in philosophy, the two words will be used interchangeably. Being moral and being ethical are the same thing. Someone who falls short of ethical standards is unethical or immoral: these terms are also interchangeable.

In order to see why professions and professionals must be held to specific ethical standards, we need to know more about how the professions differ from other jobs.

1.2. What are the professions?

For starters, the following fields are considered to be the core professions.

Medicine and Healthcare Professions

Physicians, surgeons, nurses, pharmacists, dentists, veterinarians, and other healthcare practitioners are considered professionals due to their specialized education, licensing requirements, and adherence to special ethical standards in providing medical care.

Law

Lawyers, judges and their paralegals and law clerks are part of the legal profession. They typically undergo extensive education, training, and must adhere to a code of ethics. The legal profession plays a crucial role in upholding the rule of law and providing justice. Do not confuse “law” with “law enforcement.”

Engineering

Civil engineers, mechanical engineers, electrical engineers, and other engineering professionals must meet rigorous educational standards. They use scientific and mathematical principles to design, build, and maintain infrastructure, machinery, and systems. Advanced engineering makes modern life possible, and given the complexity of their work, there are serious consequences when their projects are improperly designed or, worse, fail. Therefore, this profession has a special duty to ensure the safety, durability, and reliability of the projects they engineer.

Accounting

Accountants and auditors are recognized as professionals due to their specialized knowledge in financial matters and because their work is an important public service. For example, accountants audit businesses in order to determines their financial situation and continued viability. Obviously, this is a service to the business itself. However, investors and potential customers need objective, independent financial assessments of businesses in order to make informed decisions when dealing with them. Therefore, accounting is an essential public service in the modern economy. Accountants often hold professional certifications such as Certified Public Accountant (CPA) and adhere to ethical standards in financial reporting and auditing.

Teaching and Education

Educators, including teachers and professors, are traditionally considered professionals. They undergo specialized training in both pedagogy (i.e., teaching methods) and subject matter expertise. Their basic aim is to support the intellectual and personal development of students.

Architecture

Architects are responsible for designing and planning buildings and structures. They typically undergo extensive formal education, gain practical experience, and are generally licensed by regulatory bodies. Like engineering, this profession has a special duty to ensure the safety, durability, and reliability of the projects they design. When architects work on large and complex structures, they frequently work in close consultation with engineers.

Counseling

Counselors and some specialized types of psychologists provide mental health services. They undergo specialized education and training and generally earn advanced degrees. Because they typically work with highly personal and sensitive information, they are expected to uphold the highest standards of patient confidentiality.

Military

Professional status is assigned to commissioned military officers (ranks of second lieutenant or ensign or above), who are currently required to hold a four-year college degree and who receive additional advanced training in their decision-making capacity. Because the military is highly hierarchical, there is a vast difference in education and training at the lower and higher levels. “Enlisted” men and woman need only a high school education and are expected to unquestioningly obey those above them in rank. Therefore, professional status only applies to officers trained to engage in complex decision-making, strategic planning, organizational leadership, and other operational decision making. Much like social work, the military is regarded as a profession but not everyone in it is considered a professional. Unlike the other major professions, the military is not a consulting profession, and there are no clients in the ordinary sense of clients seeking advice. Because it is hierarchical, the the military is a paternalistic profession.

Social Work

Social workers provide services to individuals, families, and communities to address social and emotional issues. Typical roles include case management in government agencies, staffing of substance abuse facilities, and assisting in group homes. While much of this work can be carried out by anyone with a college education, this work is normally managed or supervised by social workers possessing specialized education and training and state-regulated licensing. It is the presence and supervisory work of these individuals that gives professional status to the very broad field of social work.

Social work becomes a profession

Jane Addams was a key figure in the professionalization of social work. She pioneered the settlement house movement and established Hull House in Chicago in 1889. This initiative centralized services that addressed the social and economic needs of the poor, particularly immigrants. Her leadership in founding organizations like the National Association of Social Workers (NASW) provided a professional network and standards for modern social work practice.

 

 

Born in 1860, Addams was among the first generation of American women permitted a college education, and she became committed to the need for professional training and education for social workers. She collaborated with universities to develop social work curricula, leading to the establishment of social work as an academic discipline grounded in a structured, evidence-based framework. Addams argued that traditional prejudices and assumptions must be set aside in favor of a factual understanding of the social environment, including examination of the practical results of different charitable interventions. She was a forerunner of the ideas that are today discussed under the concept of effective altruism. Given the limited resources that are directed at helping disadvantaged groups and individuals, she concentrated on social services for children.

Addams was among the first to say that social workers must be nonjudgmental about their clients, and also that effective social work should address systemic problems of poverty, ignorance, and disease. Many social problems arise from the undemocratic class structure of American society. Consequentially, addressing them requires a strong commitment to social justice.

Thus, Addams’ work emphasized the role of social workers as agents of social change. She warned that private charity is generally warped by the interests of the donors, and it is too often directed at ineffective efforts favored by the wealthy class. Recipients of charity are generally excluded from the conversation about what would be of genuine help. Addams cautioned that private donations too often function as “soap” for the dirty hands of private interests who do not support the degree of social change required to solve the underlying problems. To be effective, social work should look for change though improved government programs and public institutions. Left in private hands, she warned, social work will not achieve its purposes.

1.3 Questionable Cases

The professional status of some other occupations is less clear. In some ways they are like the professions mentioned above. In other ways they are very different. Two prominent examples are religious ministers (clergy) and most financial advisors.

Ministry includes priests, ministers, preachers, rabbis, imams, and others who provide leadership of a church or a religious community. This chapter will use “minister” as a generic term.

Historically, the ministry was hierarchical, like the military. Ministers were required to have advanced training and education, and many prestigious universities arose to educate them. However, recent centuries have seen an erosion of that standard. Today, a number of religious groups enroll ministers who have little or no specialized training. For example, there are churches that will register anyone over the age of 18 as a minister if they will endorse the church’s basic beliefs, without further qualifications. Granted, that is an extreme case, and most ministers are required to possess at least some minimal training. However, the qualifications for ministry vary widely across different denominations and faith traditions. Furthermore, American clergy are generally permitted to provide limited forms of counseling without requiring them to obtain a professional license. Consequently, many American clergy engage in crisis, marriage, and family counseling despite receiving no education or training in the best practices of counseling and psychology. Furthermore, ministry is not structured to serve the wider public good. Assistance often depends on agreeing with their values, or being an established member of the congregation. Combining these reasons with the variability of accreditation standards, ministry is not regarded as a profession.

At one time, banking and the associated field of financial advising and planning were regarded as core professions. Today, however, many financial services are offered by individuals who do not operate with the normal expectations of professionals. In the United States, there are no regulations about who can call themselves a financial advisor or planner, and no training is required to start a business that sells services under these descriptions. Generally, only those individuals who have the legal status of Certified Financial Planner should be considered professionals. They are distinguished from other financial planners by pledging to maintain a fiduciary relationship with clients. (See Chapter 2.) Because so few meet the educational standards required for this certification, it is a mistake to view the general area of banking and financial services as a profession.

1.4 Basic features of the professions

Roughly 14% of the American population enjoys the sport of golf on a regular basis, nearly double the number who participate in even one game of baseball in a typical year. Yet only a tiny fraction of golfers can be classified as professional golfers: about one tenth of one percent of those who play golf get that title. There is even an organization for them, the Professional Golfers’ Association of America (PGA). However, this use of the term “professional” is not what is meant by the word in the context of professional ethics. The PGA is uses the term in a broader, looser sense that indicates it’s an association of people who make their living through the sport. Here, “professional” simply means it’s what one does to earn a living, as opposed to those who do it as a hobby.

Similarly, one can find many online music performances in which the vocalist begins by saying, “I’m not a professional singer, but …”  Likewise, someone who self-publishes their fiction stories on the Internet might say, “I’m not a professional writer, but I hope you’ll enjoy my work.” In both cases, they are communicating that they lack specialized training and that this is a hobby: they do not do it to earn a living.

However, the professions that are subject to professional ethics are different from other jobs. As observed at the start of this chapter, the professions provide the expertise to address basic needs in complex, modern societies. Each professions is differentiated from the others according to the basic need it addresses. (See Chapter 4, Section 4.6.)

Returning to the list of core professional fields listed in Section 1.2, they share four characteristics. These four features are not strict requirements, since there is variation among the professions and different legal expectations in different states. However, a field or occupation that displays none of them is certainly not a profession in the sense that medicine and accounting are professions.

1. Professionals provide services that address basic human needs, and these services are based on expert knowledge. The different professions specialize, with each one providing services addressing distinct needs. Generally, a profession emerges as a distinct profession only if the structure and complexity of modern society has made it difficult for most people to address those needs without the aid of people with advanced training and expert knowledge in that area.
2. In contemporary society, delivery of these services is reserved for people with advanced training and intellectual expertise. Although there are various exceptions, the training is typically structured as a 4-year college degree or more. Again, subject to some exceptions, the major professions have a legal monopoly on providing specific services, and only trained professionals can charge a payment for these services.
3. These services cannot be fully standardized. Frequently, services must be selected or even redesigned to address individual situations based on specific circumstances of clients who need help in addressing their needs.
4. Activities undertaken to provide professional services are governed by a distinctive moral code, and those who participate in the professions are expected to understand how these ethical standards apply to their work.

There are other important characteristics of professional life, but it is important to understand these four before going on to others.

Consider the basic physiological needs of food and water. Basic self-maintenance requires providing oneself with food and water on a regular schedule. At the same time, self-maintenance demands not just any food and water, but nutritious and sanitary food and water. The average person can no longer go down to the river with a bucket and get water to drink, or go out into the forest to trap game and forage. As a focal point, consider the vast complexity of modern engineering that insures you have clean, safe water when you operate a faucet. Consider also the complexity of the engineering required to address the other half of the equation: people living together in towns and cities need a system to remove and treat the human waste they produce on a mass scale. Before modern engineering started to address and solve these issues in the nineteenth century, many towns and most cities faced routine outbreaks of cholera, diarrhea, dysentery, and typhoid. Waves of people fell ill on a regular basis, and it was not unusual for contaminated water to kill many of those who became sick. (For  detailed discussion, see Chapter 7, Section 7.5.)

Notice that this example mentions engineers and not plumbers. This is not to deny that plumbers have expertise when it comes to installing and repairing the complex systems that coordinate delivery of safe water to people while also handling waste products, especially human waste. However, this work does not require any special expertise in the intellectual field of engineering hydraulics. The basic designs and techniques used by plumbers were developed more than a century ago, and plumbers work within the established framework. Therefore, plumbers are not trained to do complex design work. Instead, this task is generally left to the more specialized group of plumbing engineers. This is a specialized area of mechanical engineering, and many of its practitioners have a special certification from the American Society of Plumbing Engineers.

In summary, plumbers have specialized training and are generally licensed by some oversight group, but the basic work is hands-on application of standardized procedures. Plumbing engineers design systems, and plumbers install them, so the work is divided between professionals and non-professionals. A plumber might plan out a basic bathroom remodel, but the the design process for of a large building typically calls for the expertise of a plumbing engineer.

At this point, it is necessary to introduce one of the key phrases in professional ethics: the client.

People who receive services from a professional should not be reduced to the status of customers. It is more appropriate to refer to them as clients. A customer buys a product or service. In contrast, a client is someone who needs and seeks expert advice. There may or may not be a product sold in the process. Instead, the most essential service for clients (rather than customers) is the availability of technical, individualized expert advising.

Professional advising is tailored to what is in the client’s best interests. The term “customer” (or, worse, “consumer”) implies that the professional should not assess the needs of the person who buys services. If a customer wants to buy a new mattress every month and keeps returning to the same store to purchase one, the seller is not going to refuse to sell it on the grounds that it’s not needed. However, someone who similarly tries to update their eyeglass prescription every month will find that no responsible optometrist is going to cooperate. It’s not a needed service. (On a side note, there is an emerging trend of saying “service user” instead of client, and this is likely to degrade the status of professionals even further, removing the human professional from the equation and treating their expertise as a product for use and downplaying the importance of the professional’s technical assessment of the client’s situation.)

There is no denying that a plumber must be prepared to offer expert advice when needed. However, that is a relatively limited part of the occupation, and the level of technical expertise is minimal. A plumber’s apprenticeship and training concentrates on manual tasks, with limited time spent on intellectual tasks of problem-analysis and consulting. However, technical consulting and advising is the core activity of professional life. In some ways, a surgeon might seem very similar to a plumber because the surgeon engages in the hands-on work of performing surgery. However, the typical surgeon spends the majority of their work time outside of the operating room. Their time is predominantly spent on consulting with patients, analyzing their cases, monitoring results, researching cases, and keeping current on new developments and procedures.

Consequently, a surgeon’s patients are classified as clients and not simply customers.

Consider another health-related example. Health can be defined as physical and psychological well-being. Because bad health is normally considered undesirable and an obstacle to happiness and individual flourishing, health is a basic human need. Suppose Travis is having a mild muscle soreness after over-exercising. Travis does some Internet “research” on what to do for it and then goes to the local convenience store and purchases ibuprofen to relieve the pain. Although Travis took only the recommended dosage, the side effects of dehydration soon appeared, and Travis ends up paying a hefty fee for a visit to the local rapid-care clinic. If Travis had gone to a pharmacy instead of the convenience store, two minutes of consultation with the pharmacist would have steered Travis to naproxen instead of ibuprofen. Travis has been on blood pressure medication for a number of years but had never thought about the unhealthy interaction of ibuprofen and the blood pressure medications. Pharmacists are specialists in the topic of drug interactions, and if Travis had asked the pharmacist for advice, the side effect of rapid dehydration could have been avoided.

In short, the convenience store sells pain medications to customers. In relation to the same products, the pharmacy has customers who buy products, but those customers are also, in relation to core services, clients.

1.5 Disputed and borderline cases

Given this idea, what should we say about law enforcement officers? What about real estate agents? What about journalists? Are they professionals in the meaning of “profession” that we are examining?

Many people think of law enforcement as a profession. This is tempting, because safety is a fundamental need and law enforcement is an important modern innovation dedicated to social regulation and safety. However, there are several strong indicators that law enforcement has not yet organized itself into a profession. First and foremost, law enforcement has not developed a standardized and generally enforced educational path. While some law enforcement officers have degrees in criminal justice, it is not required. Many people enter the field through different routes, such as police academies. Many police are hired with the minimum standards of a high school diploma or G.E.D. and approximately five months of training.

A second reason to deny full professional status to law enforcement comes from U.S. legal cases about the duties and behavioral expectations of police officers. It may surprise many people to learn that police officers have no duty to help individuals or to help secure the safety of threatened individuals. U.S. court cases have made it clear that police officers cannot be held responsible for the safety of individuals they choose not to help. Surprisingly, some American courts have ruled that a police officer who chooses to issue a parking ticket rather than respond to an armed robbery has not violated any duties to public safety. (We are setting aside, for now, the issue of unjust discrimination when providing services. On that topic, see Chapter 7.) Furthermore, the courts have consistently ruled that law enforcement officers have no duty to intervene to enforce restraining orders issued against abusive individuals. Finally, law enforcement has no duty to provide other individualized service, such as providing advice. So, an examination of the basic duties of police officers indicates that individual members of the public are not clients of law enforcement, and therefore it does not function as a profession.

A recent court ruling confirms this point. In 2022, an Arizona court directly faced the question of whether law enforcement is a profession. The Arizona Board of Clemency makes recommendations about changing or reducing criminal sentences, and the guidelines for board membership limit the number of serving members who come from the same profession. This rule is intended to ensure that the board represents diverse and even competing interests. When a prison inmate objected that the Board of Clemency contained too many retired police officers, the court had to begin by deciding if law enforcement is or isn’t a profession. If not, then having a board packed with former police officers would not violate the policy. And this is just what the court ruled: “It is not regulated as other professions are, and has little of the characteristics of what is typically considered a profession.”

In contrast, consider real estate agents. Shelter is a fundamental human need, and financial security is an aspect of the fundamental human need for safety and security. In modern society, access to secure housing can be complicated. It is especially challenging for people with unstable employment, a criminal record, or a poor credit rating. Furthermore, for those who wish to own a home, the decision of where and what to purchase is among the most significant and consequential financial decisions of their lives. Real estate agents have expertise in helping people negotiate these issues.

There are several reasons why this occupation might seem to be less than a professional task. Let us focus on a buyer’s agent, hired by someone who wants assistance in buying a home. Here are three reasons to doubt that this is a profession, together with response why those reasons are weak objections.

1. Not everyone employs a real estate agent when buying or selling a residence. However, this a weak objection, because the same pattern holds for other professions. Most people will never personally hire an engineer, many will not pay for an accountant’s services even when they need them, and a surprising number of people avoid dentists.
2. The amount of training expected is at the lower end of what is common for professional life. However, this a weak objection. The technical training conducted at a level that normally qualifies as college-level education. In many states, it is more rigorous and extensive than the training required of public elementary school teachers.
3. It might appear to some that real estate agents are basically shopping assistants, like personal shoppers. After all, the primary work of a real estate agent is the task of advising potential buyers on available properties that fit both their budget and personal preferences. However, that is only a small part of their work. They are also expected to advise clients on the advantages and disadvantages of specific properties. They are expected to know about, and to base their advice on, knowledge of market trends. They also advise on negotiation strategies, and often carry out these negotiations on behalf of the client.

Finally, there are a number of professional organizations that place ethical expectations on this professional-client relationship. So, real estate agents are professionals, displaying all the characteristics outlined earlier in Section 1.4.

1.6 Professions as social organizations

So far, the emphasis has been placed on interactions between individuals and their clients. Yet we can also identify several important social dimensions of professional life associated with the collective action of professional organizations.

1. The professions are self-defining groups, and they work to limit membership to those who will adopt and uphold their standards of training, practice, and associated values. A professional is only a professional because they agree to work within a framework established by other professionals.
2. The professional organizations set collective goals. They provide collective agency that is distinct from the work of individual professionals.
3. Generally, only established members of the profession can be employed to train new professionals.

How does a profession become a self-defining entity? They do this by operating collectively through professional organizations. There are no professions that lack such organizations. However, we have already seen that some organizations use the term “professional” without being a profession (e.g., the PGA, mentioned in Section 1.4). Therefore, we must look beyond the name and see what kind of work is done by the organizations that represent the major professions.

Each profession sets standards that limit who can enter that profession. An individual may not want to spend years of study in order to become a veterinarian, accountant, or nurse. However, current professionals work together collectively to make sure that specific educational standards are met before anyone can seek licensing in their profession. “Every profession,” observes Everett Hugues, “considers itself as the proper body to set the terms in which some aspect of society, life or nature is to be thought of and to define the general lines, even the details of public policy concerning it” (Hugues, 1971, p. 364). In other words, professionals function collectively, determining what kind and level of expertise is needed to meet the public need it addresses. These organizations typically set minimum educational and ethical standards for entry into the profession, and then set behavioral standards for those who practice the profession. Often, they work with government to encode their standards into law and legal licensing.

Professional organizations should not be confused with labor unions. Unions negotiate on behalf of members and they bargain directly with employers. Professional organizations do not do this. The National Society of Accountants does not negotiate with accounting firms and other employers. Instead, they develop standards and then engage in political lobbying that results in laws that regulate the professions. Where they cannot secure legal regulation, they enforce standards that set their members apart from uncertified, less qualified workers. (Recall the example of Certified Financial Planners in Section 1.3.) The professional organizations also decide—through certification—who is qualified to work as the primary educators of their own future members. In higher education, the teachers at law schools are themselves lawyers, the teachers of future school teachers are themselves former school teachers, the instructors in social work are typically licensed as social workers in that state, and so on. (There is one notable exception to the rule that professional organizations are different from labor unions. The National Education Association, which represents public school teachers, is the largest labor union in the United States.)

The power of professional organizations is considerable. Profession organizations engage in extensive lobbying to shape regulations that govern their members and services. By influencing  and often designing the educational standards required for their profession, and then by limiting who can teach the core coursework required by those standards, each profession also ensures that its core values are taught to future members of the profession. (See Chapter 4, Section 4.4.)

There is a danger here. The professions exist to serve the public, but they are also self-defining. Because they have a total or significant control of their technical fields and services, they are sometimes self-promoting and self-serving entities. Because they function as monopolies, they have significant economic impact on everyone’s lives.

To get a sense of their role and power, we will compare the professional organizations associated with two professions: medicine and higher education. In the United States, the American Medical Association (AMA) represents medical practitioners who hold the advanced degrees of doctor of medicine (MD) and doctor of osteopathic medicine (DO), as well as those who are in the process of obtaining these degrees. The American Association of University Professors (AAUP) represents faculty (i.e., teachers, librarians, and researchers) at institutions of higher education. Because level of education varies for different faculty jobs and for different kinds of institutions, there is no fixed education level required for those who join the AAUP. Instead, the organization accepts as members anyone who is certified to teach at this level by the credentialing process of individual colleges and universities, who must in turn answer to government-certified accreditation agencies.

Setting Standards and Guidelines:

AMA: The AMA sets standards for medical ethics, practice guidelines, and professional conduct of its members. As with most professional codes, the AMA says that the well-being of the client is the physician’s primary concern. However, this pledge is meaningless unless health professionals engage with broader social issues. They promote public health initiatives and equitable access to healthcare resources. As such, the AMA sometimes takes a public position on political controversies that relate to health care. For example, the AMA says that ethical health care must be competent, equitable, and prioritize patient health and privacy, and therefore they have adopted the official position that abortion is a legitimate procedure for reproductive health and it should not be banned or criminalized. The AMA argues that the decision to utilize abortion is always a private matter between a patient and her health care providers.

AAUP: The AAUP differs from many professional organizations in not having a specific code of ethics for its members. Instead, it concentrates on basic standards for how college and university administrators deal with faculty. The AAUP does so by promoting minimum standards for academic freedom, tenure, and shared governance at institutions of higher education. The guiding principle is that faculty have expertise in both their subject areas and in pedagogy, and the latter gives them a right to participate in the governance of their institutions. The AAUP endorses the typical professional view that students suffer when education is treated as a business and when faculty are treated as ordinary employees on a business model. Although tenure and shared governance have been core values defended by the AAUP, so is the right to speak freely and publicly about higher education itself.

Advocacy and Representation:

AMA: The AMA advocates for to government and the public on behalf of physicians and the medical profession, influencing healthcare policy and other issues related to medical practice. It provides a unified voice for physicians in matters ranging from healthcare legislation to reimbursement policies. To understand the influence of the AMA, it is the nation’s third largest lobbying organization. In the 1930s, the AMA blocked federal government plans to provide health insurance to Americans. In 1949, they blocked the adoption of universal health coverage. The AMA opposed, and slowed approval of, Medicare, which provides coverage for those 65 and older. The AMA finally reversed its opposition to government funding of health care when it supported the Affordable Care Act in 2009 (our current plan to bring health insurance to low-income people).

AAUP: The AAUP advocates for academic freedom, shared governance, and fair employment practices within higher education. One of the AAUP’s most notable achievements was a 1967 Supreme Court decision (Keyishian v. Board of Regents) that upheld their long-held demand for academic freedom. Academic freedom is the right of college and university faculty to engage in controversial research and to teach controversial subject matter. However, there is evidence that the advocacy power of the AAUP is weakening, as some state legislatures have prohibited the teaching of some controversial topics as a way to suspend the right of faculty to discuss controversies in the classroom. The prohibited topics generally involve race and gender.

Education and Professional Development:

AMA: Provides educational resources, continuing medical education opportunities, and support for physicians to stay updated on medical advancements. JAMA, the Journal of the American Medical Association, keeps AMA members up to date on the latest medical developments.

AAUP: Offers resources and support for faculty development and provides forums for the exchange of ideas and best practices in higher education. Publishes The AAUP Journal of Academic Freedom.

Legal Support:

AMA: Provides legal advocacy and resources to physicians facing legal challenges related to medical practice.

AAUP: Offers legal support and resources for faculty facing issues related to academic freedom, tenure, or employment disputes.

1.7 Licensure

Go back to Section 1.2 and review the list of professions. All of them involve licensing (generally at the state level). Before any individual can offer their services as a medical doctor or engineer, they must meet a set of requirements and obtain a license to operate in that profession. Licensing requirements typically include a specific course of education. Other licenses require candidates to pass a challenging test, proving their expertise. Lawyers, certified public accountants, and nurses all have to take special tests in order to obtain their license. Many social work positions are reserved for those who pass a special licensing exam. There are also negative requirements: one cannot receive licensure or certification for most professional jobs if one has been convicted of certain crimes. For example, criminal sexual conduct, serious drug offenses, and mistreatment or the use of force or violence against a minor are among the many crimes that will lead to a denial of a Minnesota teaching license.

However, being convicted of a crime is not itself the basic reason why professional licensure is denied. The underlying reason is that these behaviors are evidence of a lack of moral character. For this reason, Jeronimo Yanez was rejected in 2024 when he applied for a Minnesota teaching license. Yanez had been a police officer and stopped a vehicle driven by Philando Castile. When Castile revealed that he had firearm (for which he had a permit), Yanez fired seven shots at him, nearly harming a child in the car and killing Castile. Although a jury acquitted Yanez of any crime, the Minnesota Professional Educator Licensing and Standards Board refused to give a teaching license to him when he tried to change careers. They ruled that he had racially profiled Castile and had put others at risk. In the view of the Licensing and Standards Board, a person of this sort cannot be trusted with the care of children.

The idea is that if an individual has demonstrated that they are unable to hold themselves to the moral standards that are needed to be of service to others, that person cannot be a professional. If this seems harsh, note that personal autonomy and self-regulation are also integral aspects of professions. Professionals generally have a high degree of personal autonomy when carrying out professional services. They generally conduct most of their work without any direct supervision by others. Coupled with the responsibility to regulate their own conduct, professional autonomy is a strong reason to screen out individuals who have shown lack of self-control and a failure to treat others with due concern. (For more on this topic, see Chapter 4.)

As these points suggest, professional occupations demand a public commitment to a shared code of ethics. Professionals are expected to adhere to a set of principles and values that guide their behavior, ensuring the welfare and trust of those they serve. Ethical considerations play a crucial role in maintaining the integrity of a profession and building public confidence. (See Chapter 3 for more on the topic of integrity.)

Furthermore, a sense of duty and service is inherent in professions. Practitioners should be committed to serve both individual clients and the greater good. Those who enter the professions without this commitment—as a mere job—will struggle to understand and fulfill the duties of professional life.

Lastly, ongoing professional development is essential. Professions evolve with advancements in knowledge and technology, and professionals have a duty to engage in continuous learning to stay current in their field. Continued licensure is often tied to a minimum annual amount of continuous learning in the field.

1.7 Concluding Summary

Professional ethics concentrates on a cluster of occupations that are distinguished by the presence of four features. (1) The professionals serve the public good by addressing basic human needs. (2) The ability to address those needs typically demands expert knowledge and specialized training, and professionals supply this expertise to clients through consultation and advising. (3) Individuals and their circumstances differ widely, and therefore assistance cannot be fully standardized. Frequently, it must be tailored to individual circumstances. (4) Because they are entrusted to address satisfaction of basic needs, professionals are held to a high moral standard.

Professional organizations set standards for the education and behavior of their members. In return for delivering high quality professional services, society grants the major professions an exclusive (or nearly exclusive) right to control and profit from their area of expertise. Generally, professionals either receive certification from a professional organization, or obtain a license to work in the profession, or both.