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About this book

Ethics are central to the caring professions. The very idea of a profession stakes a claim on the ethical basis of knowledge and skills. In this book Richard Hugman examines new approaches in ethics and applies these to the practices and organisation of the caring professions. Hugman addresses debates about the relationship between the individual person and social structures, about pluralism and the possibility of universal values, about the challenges created by industrial society and technology, and about the changing social mandate for the caring professions. These debates are considered from the perspectives of liberalism, feminism, ecology, postmodernism and constructivism. Ideas are explained and the implications for professional ethics are explored using illustrative examples from practice to show their relevance for the caring professions.

This book will be essential reading for members of caring professions (especially allied health, medicine, nursing, psychology, social work and teaching) and students entering these professions.

Table of Contents

Chapter 1. Contemporary Professional Ethics

Ethics should be of concern to everyone. We can no more avoid facing moral issues than we can avoid breathing. It is impossible to think of human society without recognising the role that moral values and beliefs play in the way in which day-to-day life is conducted. Our ideas about what is good and what is right are woven into the fabric of thought and action so that, whether we are conscious of it or not, they affect our wishes and our choices.
Richard Hugman

Chapter 2. Key Debates About Ethics

In the previous chapter, the historical background and predominant contemporary approaches to professional ethics were outlined and discussed. Four broad questions emerged from that analysis and in this chapter will be considered as key debates in understanding ethics in theory and in practice.To what extent is professional ethics to be understood as universal or as particular? Should professional ethics be seen as binding or guiding professional practice? Is professional ethics explicit or implicit in practice?
Richard Hugman

Chapter 3. Why Professional Ethics?

Any discussion of ethics in the caring professions must address the question of the nature of ‘profession’ in order to give scope to the ensuing analysis. Understanding the social phenomenon of professions and professionalisation has been of interest for a long time and has attracted controversy and debate (Freidson, 1994). The purpose of this discussion is to look specifically at ethics within the caring professions rather than to explore the idea of ‘profession’ in a more general sense. Nevertheless, some preliminary comments are necessary, to ground our review of the reasons why a concern with ethics in the caring professions is important by briefly reviewing current thinking about their social terrain.
Richard Hugman

Chapter 4. The Intelligence of Emotions and the Ethics of Compassion

Since the classical era, western moral philosophy has emphasised reason as the human faculty through which what is ‘good’ is known and from which ‘right’ actions follow. Reason thus became the foremost faculty to guide ethics, emphasising impartiality as a key value (Blum, 1994; Pizarro, 2000). The opposite of reason, in this view of human experience, is emotion. From the classical Greek philosophers, through medieval Europe, to the post-Enlightenment modernists, emotion has been widely regarded as insufficient to form any solid ground for a reliable ethics, whether as a philosophy or as a practice. Emotions, from this perspective, are unreliable and unruly, irrational precisely because they are subjective and particular.
Richard Hugman

Chapter 5. Feminism and the Ethics of Care

Arguments for an ‘ethics of care’ have grown from a debate in moral psychology, in particular that between Kohlberg (1981, 1984) and Gilligan (1982). Kohlberg’s extensive, transcultural research on moral development argues for a hierarchy in which the most basic level is one at which moral behaviour follows from learned obedience and avoidance of punishment, while at the highest level a person is capable of identifying complex moral issues and applying universal and abstract principles. Gilligan challenges this model on the grounds that the research sample was entirely male. When Gilligan conducted a different experiment with young women she observed that values of caring for others and maintaining social relationships were predominant. These are the middle stages of Kohlberg’s hierarchy, which he termed ‘conventional morality’.
Richard Hugman

Chapter 6. Ecology and the Ethics of Life

In this chapter, I want to examine the influence of ecological thinking and the perspective that may be defined as ‘ecologism’ (Smith, 1998, p. 1). Although it has made a mark in political and social life, and may have been embraced by individual professionals, ecologism has not been widely considered from the perspective of professional ethics. In some ways, this could be seen as surprising, as the concepts on which ecological debates are based are also found in professional ethics, such as ‘care’, ‘justice’, ‘need’ and ‘responsibility’ (Park, 1996; Cairns, 1998). As we will see, ecology not only connects with issues of virtues and care, but also raises questions about the ways in which the dominant ethical approaches (deontology and utilitarianism) can be addressed in pluralistic principles.
Richard Hugman

Chapter 7. Postmodernity and Ethics Beyond Liberalism

As we saw in Chapter 1, the historical development of ethical thought in western society can be seen in terms of successive eras that are characterised by different world-views. Contemporary approaches to ethics are grounded in the liberal individualism that has distinguished the ‘modernist’ period of industrial society that followed the European ‘Enlightenment’. Both deontology and utilitarianism embody this world-view, which privileges rationalism and positivist science against tradition, religion and other ways of seeing the world that increasingly were regarded as ‘irrational’. Principlism is derived from an interplay between the two. However, in the late twentieth century critiques of the dominant modernist position began to influence social and moral thought in a wide-ranging movement of thinking that has come to be known as ‘postmodernism’.
Richard Hugman

Chapter 8. Discourse Ethics:Constructionism or Critical Realism?

In the previous four chapters we have examined major developments in ethics that in the latter part of the twentieth century began to present challenges to the dominant ways of looking at ethics in the caring professions. As Tronto puts it, ‘ the hegemony of Neo-Kantian ethics has been challenged by moral theories that rely upon compassion, care, the emotions, and to some extent, communication’, drawing on a variety of perspectives that share roots in the ideas originally set out by Aristotle (Tronto, 1993, p. 149). So far the discussion has focused on compassion seen as an intelligent emotion, the ethics of care, the ethics of ecology and of postmodernity; it has emphasised questions of emotion, perception, context, character and virtue, subjectivity and inter-subjectivity. In this chapter the other element that is identified by Tronto as part of changing approaches to ethics will be considered, namely that of communication.
Richard Hugman

Chapter 9. Re-evaluating Professional Ethics

In the previous chapter the idea of discursive ethics was discussed as a basis for a practical response to ethical pluralism. This chapter looks at the challenge that a discursive approach creates for the re-evaluation of professional ethics, examining in particular the implications of contemporary ideas for codes of ethics. Four substantive approaches to ethics have been considered in detail in Chapters 4 to 7: the ethics of compassion as an intelligent emotion; the ethics of care; the ethics of ecology; and postmodern ethics. Each chapter examined a substantive approach in relation to key aspects of the caring professions that were outlined in Chapter 3, that is the content (practices), the focus (objectives), the social relations and the social mandate of these professions.
Richard Hugman

Chapter 10. Discursive Professional Ethics

Finding ways to ensure that ethics is seen as a primary concern in the caring professions (in the contemporary idiom, that it is recognised as ‘core business’) is as pressing as it has ever been (Balogh et al., 1989). There are pressures to conflate ethics with rules for conduct or defences against complaints and lawsuits, or even to regard ethics as optional. Stevens (2000) notes that attending to ethics can be difficult, challenging and sometimes quite risky. Consequently members of the caring professions may be drawn to rationalisations that explain away the ethical dimensions of practice. The list of possible defences against engaging with ethics includes:
Richard Hugman
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