It’s a pretty warped understanding of professionalism that would require professionals to violate their own sincere ethical beliefs. After all, someone lacking personal integrity probably isn’t going to be much concerned with professional integrity. “You can trust me because I lack the strength of my convictions.”
I think the connection between personal integrity and professional integrity is an important one, so here are some preliminary thoughts on it.
Joining a profession requires some buy-in to the shared values of that profession.
If your first priority, as a matter of individual conscience, is to do harm, joining a profession whose shared values are expressed with the slogan “First, do no harm” strikes me as a really bad idea. Minimally, you’re putting personal ethics and professional ethics on a collision course, where staying true to one necessitates violating the other.
I mention this as a way of suggesting that there may be limits on how much respect a profession can afford for the personal convictions of its members.
Letting values guide your actions starts at home.
Can a person who has no personal integrity really feel herself bound by the values of a profession she has joined? It might be possible, but it does seem reasonable that some pre-existing relationship with rational reflection about what you ought to do (as a person) might be useful practice for the activity of rationally reflecting on what you ought to do as a member of profession X. And, it’s hard to know for sure whether the people who are really good at lying (for example) in their personal lives might also be lying in their professional lives — either to the other members of that profession, or to the folks with whom members of that profession interact as part of their profession.
Can I cultivate my personal integrity and still fulfill my professional duties?
In the specific case of pharmacists, I’m inclined to say that there may be a way to respect the conscience of the individual and still discharge the professional duty. But a crucial element here is that cultivating my personal integrity requires that I treat other persons — and the deliverance of their conscience — as worthy of my respect. In other words, looking out for what my conscience requires ought not to give me license to dismiss the values and interests of others, particularly those others with whom I interact professionally.
Practically, this means that we’re not witnessing the cultivation of personal integrity if a pharmacist actively thwarts a client’s efforts to fill a prescription for emergency contraception in order that she not be able to obtain it during the 72 hour window in which it is likely to be effective. Nor does it count as cultivation of personal integrity to tell a client she will go to Hell if she uses RU-486 to terminate a pregnancy. Neither of these respects the client as a moral agent whose values matter in the interaction. To a certain extent, both involve the exercise of paternalism.
Let me suggest that any personal integrity worth cultivating includes at least some minimal level of respect for other persons. The fact that my values may differ from someone else’s should not automatically lead me to conclude that mine are right and that the other person, therefore, need not be considered part of my moral community. Respecting that other person might, in some cases, require me to engage him about our differences in values. But there’s a world of difference between respectfully trying to change someone’s mind and unilaterally imposing one’s own moral judgments on someone else who does not share them. Even “engaging in dialogue” is hard to do respectfully if there are power disparities (e.g., I have the power not to fill your prescription unless you listen to what I think of your values).
Being a professional gives you a certain kind of power with respect to the folks your profession serves. This is a good reason to have professional codes that spell out your duties as a professional. To the extent that the individual within that profession cannot fulfill one of those duties without violating her personal integrity, she has a duty as a member of that profession to be able to find someone else in that community who can fulfill that duty.
And finding another member of the profession who can fulfill the duty in question shouldn’t be hard, because if one is cultivating personal integrity and understands that professional membership is defined (at least in part) by a set of shared values, then that person should be engaged in conversations with others around the contested values.
If no one in the profession is behind a particular value, that profession ought to drop it from the set of shared values that direct the duties of that profession. And if someone is serious about being a member of a profession, one ought to be committed to enaging seriously and respectfully with the other members of that profession.
There’s undoubtedly more to say about this, but I’m out the door. Please use the comments to flag glaring mistakes or omissions.