Learning How Professionalism Evolves

As a pot is slowly brought to boil, the frog within, failing to notice the change, never jumps out. Likewise, radiologists may fail to perceive deleterious changes in the character of their profession because they unfold over such a long time. In radiology, one aspect that has changed slowly but dramatically over the years is professional ethics. Having no experience with how professional standards were advocated and taught just a few decades ago, many younger radiologists stand little chance of perceiving seismic shifts in the discourse of medical professionalism.

Changes in the way we think, talk about, and embody professional ethics bear profound implications for our understanding of what it means to be a professional. To begin to appreciate the richness of shifting perspectives and their sometimes widely divergent implications for professional self-understanding and conduct in radiology, it is illuminating to look at the evolution of professional ethics in another field. Having trained our eyes to view such shifts with more dispassion because they took place elsewhere, we can peer more deeply into similar transitions taking place in our own.

Here, we focus on the law and its lessons for radiology. The history of legal ethics in the United States can be divided into three eras, which correspond to three sets of standards that the American Bar Association (ABA) adopted to guide the conduct of lawyers in the United States. The first era is reflected in the Canons of Professional Ethics, the second in the Code of Professional Responsibility, and the third in the Rules of Professional Conduct. Each of these standards rests on different assumptions about the context and purpose of professionalism, including what it means to be a lawyer.

Canons of Professional Conduct

Although the Canons of Professional Conduct were adopted in 1908, their roots can be traced back to the mid-19th century, when most lawyers were educated by self-study, supplemented by apprenticeship with practicing attorneys. One of the better-known guides for an aspiring lawyer’s self-study was David Hoffman’s A Course of Legal Study , a 7-year program of study that included a prayer before the study of law by Samuel Johnson and a list of student resolutions that included “To live temperately,” “To oppose indolence,” and “To note my daily deficiencies and endeavor to correct them” .

Hoffman’s course was founded on the view that the law is a coherent, well-ordered system that originated in the law of nature, and that the study of law led naturally to human flourishing. By studying the law, in other words, lawyers-in-training would become better human beings. As a result of this assumption, the original edition of A Course of Legal Study did not include specific ethical guidance for lawyers . Yet, as more men with more diverse backgrounds were attracted to the law, Hoffman concluded that some practical guidance for practicing lawyers would be helpful. As a result, he developed a set of “Resolutions in Regard to Professional Deportment.” Almost the entire substance of the Canons adopted by the ABA can be traced back to these 50 resolutions .

Perhaps even more importantly, the Canons reflected the purpose of Hoffman’s resolutions, for neither was intended to serve as rules or regulations. Instead, they were exhortations to enrich lawyers’ characters and make them better lawyers. They did not restrain lawyers so much as empower them to become improve. To study law was not merely to acquire particular kinds of knowledge and skills but to adopt a way of life and become a certain kind of person.

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Code of Professional Responsibility

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Rules of Personal Conduct

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Consequences of the Shift

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Radiology

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References

1. Hoffman D.: A course of legal study: addressed to students and the profession generally. Available at: https://archive.org/details/acourselegalstu00hoffgoog
2. Ariens M.: American legal ethics in an age of anxiety. St Marys Law J 2008; 40: pp. 354-355.
3. Ariens M. p. 351.
4. American Medical Association : Code of ethics. Available at: global.oup.com/us/companion.websites/9780199774111/doc/VI.doc
5. Ariens M., p. 439.
6. Fuller L.L.: The philosophy of codes of ethics. Electrical Engineering 1955; 74: pp. 916-918.
7. Fuller L.L.: The morality of law: revised edition.1969.pp. 3-30.
8. Fuller L. p. 6.
9. Fuller L., Randall J.: Professional responsibility: report of the joint conference. Am Bar Assoc J 1958; 44: pp. 1159-1161. Ariens notes that the Code cited this report twenty times. See Ariens, p. 439
10. American Medical Association : Principles of medical ethics. Available at: https://www.ama-assn.org/sites/default/files/media…/ethics/1957_principles_0.pdf
11. American Bar Association : Model rules of professional conduct. Available at: https://www.americanbar.org/groups/professional_responsibility/publications/model_rules_of_professional_conduct/model_rules_of_professional_conduct_table_of_contents.html
12. Kutak R.J.: The law of lawyering. Washburn Law J 1983; 22: pp. 413-428.
13. Patterson L.R.: Wanted: a new code of professional responsibility. Am Bar Assoc J 1977; 63: pp. 639-642.
14. Patterson L.R. p. 639.
15. Hazard G.C.: The future of legal ethics. Yale Law J 1991; 100: pp. 1278-1279.
16. American Board of Internal Radiology : Medical professionalism in the new millennium: a radiologist’s charter. Ann Int Med 2002; 136: pp. 243-246. Available at: http://annals.org/aim/fullarticle/474090/medical-professionalism-new-millennium-radiologist-charter
17. Pound R.: The lawyer from antiquity to modern times.1953.pp. 5.
18. Latham T.: The depressed lawyer. Psychology Today ; Available at: https://www.psychologytoday.com/blog/therapy-matters/201105/the-depressed-lawyer See also, Rhode, D., The Profession and its Discontents, Ohio State Law Journal 2000:61:1–13. Available at SSRN: https://ssrn.com/abstract=233254

Learning How Professionalism Evolves

Canons of Professional Conduct

Code of Professional Responsibility

Rules of Personal Conduct

Consequences of the Shift

Radiology

References

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