Thursday, August 26, 2010
college Faculty Professionalism – Ethical Responsibility and Precarious Work Pt. 2.2
2.2 The crisis of professionalism
A foremost proponent of the social contract view of professionalism, William Sullivan, is well-known for his discussion of the erosion of what he calls the “professional ideal” experienced in certain fields over the last 40 years or so. Sullivan’s analysis focuses on two key factors in the decline of professionalism. One is the rise of public doubt that professionals in a field are truly committed to benefiting the public. Public perception of the negligence or greed of physicians, for instance, led to widespread mistrust and demands for greater client autonomy, bureaucratic regulation of the field, cost containment, etc. A contemporaneous shift in political and economic understandings of the role of professionals has had as much, if not a greater part to play in the changing circumstances of professional labor. Public suspicion of professional peer review and tenure has been both aroused and exploited by those driving the agenda of “frictionless capital,” “privatization,” and “market solutions” (Sullivan, 17) – the economic ideology that considers all goods to be essentially private interests to be pursued by private means and actions. Under that “simplistic” (Sullivan, 17) conception of human interests and professional work, professional self-regulation appears illegitimate, and only bureaucratic regulation or market-driven competition appear as legitimate principles for the organization of the labor provided by members of “professions.”
As a result, many professions have entered a period of crisis. Through a rough and unstable compromise between ideological factions in US political life, bureaucratic regulation of some sort, often subjected to measures serving the interests of market-driven owners of corporations, has come to rule many formerly more autonomous professions. The demand for oversight and control – in particular control of costs – made by the mistrustful public is made to appear to be somewhat satisfied by hierarchical control over the work of individual professionals. For example, managed care now sets limits on physicians’ conduct as part of a complex new arrangement of authority, autonomy, and resource allocation. What has not come to pass is any restoration of public trust, or renewal of the social contract of medicine. Modern medicine faces a paradox, one that Sullivan generalizes to other fields: on one hand, public mistrust continues; on the other hand, the technical advancement of medicine and increasing demand for medical care force the public to continue to rely on physicians. The result for doctors has been a trend of deprofessionalization — loss of control over their work, loss of independence, and the creation of working conditions and limitations on provision of service that conflict directly with serving the public good (Hafferty and Light, 1995). Ironically, bureaucratic measures imposed in the name of serving the public interest by controlling professional behavior have created institutional conditions of work that make it all the more difficult for professionals to serve the public interest, leading to still more decline in public trust (arguably now misplaced on professionals instead of bureaucratic constraints). For instance, legal changes demanded by consumers of medicine, but written largely under the direction of lobbying from the health insurance industry, led to the Health Insurance Portability and Accountability Act (1996). The Act’s Privacy Rule imposes restrictions on individual practitioners’ sharing of patient information, satisfying public demand for greater control over how doctors and nurses discuss their cases, but, unbeknownst to many US citizens, the Privacy Rule provides health insurers wide latitude in sharing that same information, in large part to determine whether to provide, or continue to provide, care to patients.
Sullivan argues for the need to restore professionalism as a civic ideal, through public dialogue in which the purposes and expectations of a professional field come under rational and open inquiry. For him, the crisis of professions is a wide-scale social crisis. The public still needs – in fact, increasingly needs – the services provided by technical experts, yet it mistrusts those experts, and mistrusts the bureaucratic regulatory apparatus they themselves have demanded to oversee the work of professionals.
The parallels between professional fields in crisis, and the contemporary professoriate, have been explored by Neil Hamilton, most recently along with Jerry G. Gaff in the AACU report. Hamilton’s basic account of the professional crisis of the professoriate is that “[t]he continuing failure of the academic profession adequately to socialize its members has resulted in a steady erosion of the profession’s rights of academic freedom, peer review, and shared governance” (Hamilton 1). Hamilton claims that this socialization has failed on the individual level to develop “personal conscience” and on both the individual and collective levels to lead to “professional identity formation” (Hamilton 6). Instead, Hamilton claims that the professoriate has not merely passively but actively undercut its claim to serve the public good, by corrupting tenure. According to Hamilton, in practice, the professional rights of peer review and academic freedom have been used by professors as a system of employment protection: “Job security and self-interest concerns undermine effective peer review” (Hamilton 11, citing Hamilton 2007). Hamilton also suggests a parallel between the public demand for increased bureaucratic regulation of finance, accounting and medicine with the apparent demand for similar regulation (and concomitant loss of self-regulation – i.e., academic freedom and tenure) of faculty (Hamilton 9f).
Taking the AAUP Statement on Professional Ethics as a guide for determining faculty’s responsibilities, in what specific ways has the professoriate failed to uphold its social contract? Has peer review resulted in widespread academic fraud? Has faculty self-interest led to dishonest evaluations of students? Have professors abandoned their collegial responsibilities or become lawless rogues in their institutions? Certainly there are a few who make these claims — quite often politically-motivated persons with little or no relevant and reliable evidence (Gaff, 23). In fact, the only substantial claim regarding direct failures to uphold faculty ethical responsibility in the AACU report is Hamilton’s discussion of research misconduct and the role of peer review in either failing to catch it or (more seriously) looking the other way (Hamilton, 15). Further, Hamilton cites, as a reason to doubt that faculty uphold their social contract, the existence of “only three national, multi-institutional socialization initiatives” (Hamilton, 13) — two of them federally mandated research oversight programs, the third an AACU program from 1993-2003. In addition, Hamilton claims that “[a]cademic ethics is not a significant field of study,” and this fact leads to greater public mistrust (Hamilton, 14). Gaff elaborates that the AAUP’s committee investigations of academic freedom violations is an “antiquated and increasingly ineffective” mechanism, largely because it does not enforce standards for conducting research in addition to addressing violations of faculty academic freedom. What is needed to restore the integrity of faculty work, Gaff says, is for institutional trustees, executives, and administrations to take fiduciary responsibility for faculty work, joining with faculty leaders “to recommit” to the principles of faculty ethics (Gaff 27).
Another aspect of the social contract must be discussed in order to fully comprehend the current situation. In Hamilton’s view, the social contract of the professoriate depends on a three-pronged mission of institutions of higher education, involving teaching critical inquiry along with knowledge-creating and knowledge-disseminating. It is beyond my scope here to critique the tacit and clearly positivist epistemology underlying this view, but I would like to consider its implications for the problem of identifying to whom and for what the social contract of “the professoriate” ought to apply in institutions of higher education. For Hamilton, apparently, these institutions can be distinguished into those who have the full mission of higher education and those which lack either a significant commitment to teaching critical inquiry or to knowledge-creation. In the sort of institution that lacks these elements of the mission, “it is difficult to identify a transcendent public good its teachers are serving that is different from that of high school teachers” (Hamilton, 16). In such an institution, the social contract would not apply: “without a substantial reason to justify occupational control of the work by the professoriate, such an institution may decide to manage its teachers in a way similar to the nonprofit organization model typical in a competitive market. The institution may decide to employ an inadequate number of tenured faculty to provide effective peer review and shared governance” (Hamilton, 16). In such institutions, where there are inadequate numbers of tenured faculty to advance a claim for peer review or academic freedom, the social contract of the professoriate is null and void.