What is Professionalism?
The concept of professionalism is broad and intriguing and the society’s perception of professionalism is changing over time.(1,2) It has been difficult to explain it with a single definition since it encompasses a wide variety of attributes and differing perceptions depending on the profession involved. Various researchers have attempted to define professionalism and they have identified professionalism according to their own perspectives.(3)
The term “profession” is derived from the Latin word “profess” which refers to “taking oath”.(4) Thus, the origin of the term stems from the belief that professionals have a duty towards the society that they serve. For example, doctors have a duty towards protecting or safeguarding the health of their patients. The most important aspect of professionalism is to serve the society, safeguard its interest and work for its well being and betterment.
There is no ideal definition of professionalism, however the normative definition of professionalism proposed by Swick (5) is more elaborate and encompasses most of the attributes of professionalism. The author has identified nine behaviours which must be met to consider oneself as a true medical professional. The behaviours are:
• The doctor must place the interest and needs of the patients well above his personal interest. This is an important aspect of medical professionalism and professionalism in general.
• Adoption of high ethical and moral standards.
• Any professional should work for the well being of the society that he serves and perform his duties towards the society. In other words, a professional should understand that he has a social contract with the community he serves and should cater to its needs.
• Professionals should demonstrate humanistic values like honesty, integrity, caring, altruism, respect for others, empathy, compassion and trustworthiness.
• Professionals must take responsibility for their work and those of their colleagues. In other words, they must be accountable for their actions.
• Professionals must be competent and should have a desire to excel in their field. Since medicine is an ever-growing field, physicians must constantly keep updating their knowledge and sharpen their skills to keep them abreast of the advancements in their field so as to provide better services to the patients and society. Thus, lifelong learning is a fundamental aspect of professionalism.
• Professionals should share their knowledge with others for the betterment of the society. They should work towards preserving the health of their patients and society as a whole.
• Professionals should have the skill of independent decision making at times of ambiguity and uncertainty in their work
• Reflection and deductive reasoning are hallmarks of professionalism. A good physician should be able to reflect upon the decisions taken by him, critically analyze it and make conclusions which will help him to take better decisions in future when he confronts a similar situation.
How is Bioethics related to Professionalism?
There are many attributes of professionalism, each of which is related to bioethics either directly or indirectly. Professionals, especially medical professionals have a fiduciary relationship with the society that they serve. They are entrusted to take the right decisions and act in the best interest of the patient and the society. They are expected to protect the needs of their patients over their personal benefits. This aspect of professionalism is ensured by formulation of the code of ethics and enactment of laws to enforce punishments for those who deviate from it. Thus, the patients are protected and their welfare is given priority.(6) Another important aspect of professionalism is to adhere to the moral and ethical standards formulated by the professional bodies. Thus, knowledge of bioethics helps us to enrich our knowledge regarding the ethical codes of conduct, so that we could apply the same in patient care for betterment of society.(7)
Also, many a times, a professional has to confront ethical dilemmas in his work. Clinicians face ethical problems in patient care. Medical researchers face various ethical issues in basic and clinical research. Thus, modern medical practice is associated with ethically challenging situations, where the physician is trusted upon to make the clinical judgments which are moral and ethical. These clinical decisions should also be in line with the code of medical ethics and laws pertaining to the ethical dilemma. A good professional is one who is competent enough to take the right decision which is ethically and clinically sound. Thus, knowledge and practice of bioethics is needed to demonstrate professionalism in our work.(8)
In medical research, the researcher is expected to conduct good quality research which would help advance the medical literature and identify newer modalities of treatment. A good professional should be aware of the ethical principles in doing research and follow the same. (9)
One of the attribute of professionalism is to constantly keep ourselves updated of the recent advances in our field. This is related to bioethics because if we are not up to date with our knowledge and skills, we would not be able to offer the best available treatment for the patient and it is unethical to do so. Another aspect of professionalism is to have humanistic values like respect for persons which is the fundamental principle of bioethics. In other words, patients’ autonomy should be respected by taking informed consent for medical procedures during patient care and in medical research. Similarly, incorporation of the other fundamental principles of bioethics like justice, beneficence and non-maleficence in patient care and research is needed to demonstrate true professionalism.(6) Thus, it is evident that bioethics and professionalism are intricately related to each other and an education in bioethics is important to reach the goal of professionalism.