PROFESSIONAL ETHICS and BUSINESS ETHICS Andrew Brennan Professor and Chair in Philosophy La Trobe University Melbourne Victoria

3086 Overview In many professions, potential for conflict arises from the duty to serve the best interests of the client or patient, on the one side, and the duty on the other side to look out for oneself, keep income flowing in, gain an edge over competitors, and pursue ones own happiness. How do these different duties play out in the real world of clinical practice, and running a small animal hospital while generating an income through sales of foodstuffs, grooming and other products? In particular, what risks both moral and economic do veterinarians run by diversifying their services to deal with things that are not strictly matters of medicine or surgery? The Death of Ethics? In the ideal world, there are many win-win situations. In that world, we help others and in doing so help ourselves. I find a lost briefcase, return it to the owner, and discover, to my pleasure, that there is a $500 reward for doing so. The owner gets the briefcase back, and I secure the double satisfaction of having done the right thing and being rewarded for it. In the real world, I am seen hurrying along with the briefcase, mistaken for the thief, restrained by security staff, handed on to the police and spend hours justifying myself to the authorities and establishing my good intentions. Although the owner gets back the briefcase, I suffer a double blow: my integrity is impugned and much of the day is wasted. I tried to do the right thing, but I was unlucky. Textbooks on ethics, codes of conduct and the management of ethics within business are often written as if the world is an ideal world, and so they overlook the messiness of specific moral situations. There is another feature of the present age which combines with this tendency to overlook the specific, the individual and the complex. This is what some writers have taken to be a symptom of the widespread corruption that characterises both business and the public service as they are now conducted, a corruption that the sociologist Richard Sennett calls the corrosion of character (Sennett 1998). This corruption arises in part from the following mistake: namely, the mistake of thinking that the real issue to confront in deciding what I ought to do is whether I have followed the appropriate procedures, done the job according to my position description, or that I have complied with a rule, clause or statement in procedures or in a code of conduct. The proceduralist disease has spread to many parts of government, education and the corporate world. What I mean here by proceduralism is the tendency to think of individuals in an organization as relatively isolated atoms whose behaviour is to be governed by systems of rules, policies and codes that prescribe the appropriate action for their circumstances: as if the individual person is an automaton working under the direction of a program and a system of rules that prescribes the appropriate conduct for every general kind of situation encountered in the office.

Brennan, Andrew, Professional ethics vs. business ethics. Proceedings of the AVA Annual Conference, Canberra 2012 Page A1.6.1

Veterinarians working in large organizations will be well aware of how proceduralism has set the scene for discussing matters of ethics, welfare and compliance in the last two decades. But there is a risk that the same proceduralist thinking spreads to our everyday thinking even if we work on our own or in a small practice. We might make the mistake of thinking that codes of conduct and principles laid out by professional organizations state procedures, the following of which will guarantee ethical outcomes. But this is an illusion. The problem is that proceduralism does not set or protect proper professional standards, but can instead encourage the opposite. The appeal to procedure is often used as an excuse when things go wrong, when officials within a large organization excuse horrors on the grounds that they simply followed procedures. This happened a few years ago in the case of the death in custody of an aboriginal elder in Western Australia. The victim, Mr Ward, died from exposure to searing temperatures in a locked pod mounted on the back of a small van. The airconditioning of the pod had failed. The coroner commented that the pod would not be deemed suitable for transporting animals, let alone people (Hope 2009), but from a proceduralist angle what is interesting is the testimony of one of the security officers herself a former paramedic describing the situation when they looked into the pod and saw that Mr Ward was in a state of serious collapse (with surface temperatures inside the pod around 56 degrees celsius): my first reaction in normal circumstances would have been to rip that door off its sockets and gone in there and dragged him our and done gave him mouth to mouth, but that is against our procedures (Hope 2009, 76). Like that arch-proceduralist, Adolf Eichmann, this officer followed procedures, and the result was an instance of everyday immorality, what Hannah Arendt memorably called the banality of evil (Arendt 1963). While Eichmann was executed, the officer in the West Australian case was not charged with any offence at all. Proceduralism may partly explain why corporate corruption, greed and fraud have flourished so widely in the last two decades. Its hazards may seem to be confined to large organizations, where the faith in procedures seems to have taken a hold in a way that undermines the scope for individuals to make judgments of a substantial kind. Does this mean that last stronghold of ethical practice in business is in the small organization, where the intimacy of the workplace, and the fact that employees and owners of small companies come frequently into contact with their clients and customers means that it is hard to use procedures and rules as a device for hiding from responsibility? There is a temptation to see things in this way, but it should be resisted given that as I will point out a range of ethical challenges face all people in business, no matter how small the company may be. Also, despite the appeal of proceduralism, many of those working in large-scale organizations do their best to resist its negative effects in the workplace, and continue to exercise good moral judgment in their activities. Many small businesses are themselves legal, medical or therapeutic enterprises of one kind or another, and so the issue of how best to run the business, and how best to secure sustainable profit is a question with ramifications of all kinds including social, ethical and environmental ones. Matters of sincerity and trust are central in many ways to the small business establishing relations of trust among a small workforce is connected to the ways in which the business is able to build up trust among its customers and clients, and to how effectively and sincerely it plays a range of roles in its local community. People working in small scale businesses therefore are always dealing with other people in ways that are formative of character the character of the business itself and of their own characters as well.

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Turning an ethical profit As just observed, it would be wrong to imagine that small and medium enterprises are home to standards of ethical behaviour lost in the larger corporate and government sector. Not all small businesses are good neighbours, or operate in a trustworthy manner. A plumber or engineer from a small company can inflate prices, carry out unnecessary repairs and replacements perhaps more readily than can people working for a huge conglomerate. As long as people do not realize they are being conned, cheats can flourish and a kind of unstable harmony can rule. A friend may caution against using a particular garage, or builder, but so long as the dealings of the offending business are not too excessively outrageous, it can take a long time for it to lose its clientele, and neighbouring, more honest businesses, may look on in despair. While small business may not face the ethical challenges of depersonalisation and proceduralism of the sort faced by larger organizations, real challenges still face them on a daily basis. In a small enterprise, such as a professional practice, the intimacy of the links within and among small businesses gives rise to a range of very specific ethical temptations. Should I refer a clients animal to a specialist, and given that my brother-in-law is just starting up a new practice, and has the necessary expertise would it be acceptable to refer the patient to him? Codes of Conduct recognize such temptations, and usually specify how to avoid the more obvious of these by a combination of prohibition of feesplitting and a requirement that in the veterinarian-client-patient-relationship (sometimes called the VCPR) there is a commitment to openness and declarations of any potential conflicts of interest. Different codes have different emphases. In the United States, the AVMAs Principles of Veterinary Medical Ethics puts explicit prohibition on fee splitting (AVMA 2010). By contrast, the Australian AVAs Code of Professional Conduct is silent on fee-splitting, but refers to promoting trust among colleagues a matter on which the AVMA Principles are silent (AVA 2010). While the American principles put animals explicitly into the core relationship with the veterinarian (the VCPR), the Australian code focuses on the veterinarians relationship with the client as the important one. On the other hand, the Australian code makes far more mention of animals and duties associated with their care and welfare than is found in the American statement of principles. While the Australian code is silent on the vexed issue of ethical products (over-the counter products that are sold at a premium through veterinary clinics), this matter is touched on in a brief way by the American principles, yet not in the detail that critics of such products would like to see. The recurring debate about whether raw feeding is better or worse for cats and dogs than the processed dry products used by many pet owners is a reminder of the potentially awkward questions that can raised about the relationship between veterinary associations and their commercial sponsors. At the level of the individual clinic or local veterinary hospital, the issue is acute. If a significant amount of your practices income derives from sales of certain foods and other products, can you ever recommend that one of your patients change to an unprocessed or less processed diet? If word gets around that you dont favour the commercial scientific diet in all cases, then this may have an impact on your profits from sales of formula foods. Now take this thought further. If your clients get to know how much of the practice income derives from product sales in general, then what reply do you have to the claim that commercial interests are in danger of affecting your professional judgment? The question of good nutrition is just the beginning of a series of pathways into a moral minefield.

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A neat illustration of the potential for conflict is shown in the programme for the present conference where a number of sessions focus on the profitability of selling behaviour management products. Specific behavioural aids, like head collars for dogs, automated treat dispensers and the like have been adopted by some veterinary practices as an integral part of their patient and client service regimes. Here is a situation where it is tempting to claim that there is win-win situation with scope for ethical profit making. This is because the products used and endorsed by veterinarians fit well with traditional conceptions of the veterinarian as more than a practitioner of surgery and dispenser of medical treatments of a narrowly focused kind. Like other medical professionals, the veterinarian can be a guide and a friend to a whole range of issues faced by clients and their animals throughout their lives. Such a wider role, however, carries an element of risk that has to be faced and managed. In particular, the veterinarian is often a source of advice on animal behaviour, and where individual practitioners have found that particular products help in the overall management of behavioural problems at the clinic, it looks helpful and profitable to endorse and promote such products more widely. This issue is somewhat different from the one raised by the nutrition case. The problems with behaviour modifying devices is that once outside the clinic, the head collar that worked so well can be fitted wrongly, can fail to correct other behaviours, and can cause stress and physical damage to the patient. Whats the right thing to do? In the face of such a question, statements of principles, and codes of professional conduct are no substitute for professional and ethical judgment. The issue is not so much one of following procedures, but rather of thinking the issues through in a common sense way. It is not hard to sketch out the potential conflicts of interest here the clinics profits need to be maintained if the business is to flourish and grow, the trust of clients has to be maintained, the service they receive should involve value for money, and the health and well-being of the animal patients is not to be compromised. These are the basis of an ethical check list that can be applied when considering whether to sell and endorse products like head collars. Here is a simple list of questions to ask about any product you consider for adoption and sale through your practice: What is the evidence that the product is proof against incompetent use outside the clinic? In what ways could the product cause damage to the animal? Will the product help training in the desired behaviours? Have I used and researched it enough to know the answer to questions clients will have? Would I use it myself and recommend it to my friends and family? Is the mark-up on sales too high? If I am selling it at a premium compared to internet purchases, or the price of products sourced in pet shops or supermarkets, then what extra value am I adding by selling the product through my practice? Do I need to give clients any training in the use of the product before selling it to them? These, and similar, questions are ones that probe the ethical propriety of promoting, selling and giving professional endorsement to products and are precisely the ones to ask when examining your professional conscience. In putting forward the check list of questions to ask, my assumption has been that a clinic or veterinary practice offers more to its clients than a local shop or supermarket does. By buying from a medical professional, the customers anticipate greater security and higher-quality advice than they can get from a store. This is all well and good, but remember the story of the briefcase.

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There are no guarantees that even after due diligence, proper research, training your clients in the proper use of the products you sell even after all these precautions, you as a professional are more exposed to moral danger than the local shop owners. The exposure of the professional is an inevitable consequence of his or her situation. As someone skilled, knowledgeable and learned, you are the person that others turn to because they know and understand less than you do. And your advice carries correspondingly more weight than that given by non-professionally qualified people. Now think of an outlandish example Imagine that the head collar your practice promotes works wonderfully well in many cases and brings a useful income stream. Unfortunately, in a factory far away, all is not well. A disaffected employee has added poison to the dye used in manufacturing a batch of the collars, so that animals wearing the contaminated collars suffer horrific lesions, and some die in agony from ingesting the noxious ingredient. Think how horrified you would feel about having recommended and sold such a lethal product. Even though you have acted in good faith, and you could not have been expected to anticipate such a disaster, still you would do anything to avoid being in such a position. But no amount of due diligence, prior research and customer training can guard against such an unpredictable event. Anyone caught in this situation would be plain unlucky, not guilty of any moral wrong at all. The limits to due diligence and running through ethical check lists would not come as a surprise to the philosophers of ancient Greece and Rome. For many of them, the aim of studying philosophy was to find how best to make our lives go well. They lived in a far more dangerous and unstable environment than we do. Ill health, injury and disease could strike suddenly and without warning, depriving people of their security, their livelihoods and their futures. Are there any characteristics we can cultivate, or rules that we can follow, so that our lives will go as well as they can no matter what fate and the gods throw in our paths? That was one of the primary lines of inquiry among the ancient thinkers. But search as they might, they could not find that elusive ingredient the virtues, the habits that would guarantee a good life no matter what. Aristotle concluded that for a life to go well required not just cultivating the virtues facing the future armed with courage, temperance and justice but also needed something else. Some people, he claimed, are born more fortunate than others, and some are plagued with misfortune bad luck during their lives. Being able to live well and enjoy a good life is not something entirely within our control, but instead depends to an extent on luck. Those who choose to work in the professions are more exposed to good and bad moral luck than other people. That is not something to regret, but something that requires the professional to take with due seriousness the need to be careful about the advice he or she gives, to be prudent in regard to the products sold and endorsed by the practice, and to give due weight in general to the moral risks involved in taking on a wider role than that of a practitioner of medicine and surgery.

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References Arendt, Hannah 1963. Eichmann in Jerusalem. A Report on the Banality of Evil. New York: Penguin Books. AVA 2010 Code of Professional Conduct, available on the website of the Australian Veterinary Association, at http://www.ava.com.au/conduct AVMA 2010 Principles of Veterinary Medical Ethics, available on the website of the American Veterinary Medical Association, at http://www.avma.org/issues/policy/ethics.asp Hope, A. N. 2009 Record of an Investigation into Death Reference 9/09. (Western Australia: Government of Western Australia Coroners Court, 2009) Sennett, R. (1998) The Corrosion of Character. New York: W. W. Norton.

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