Character in Context: the dilemmatic space of social work
This presentation will explore the place of character in social work, with a focus on the character of the professionals (as opposed to service users). It will consider what are the benefits and challenges of a character-based ethics for social work.
The rationale for the conference includes a statement, which suggests that:
… many latter day professional failures or ‘scandals’ …… would appear to have been attributable more to personal weakness, irresolution, greed, self-serving and sometimes just plain folly of individual practitioners: in short, to failures of personal moral character.
For those working in the field of social work, this is a provocative statement. Social work is one of the most vilified professions, in which practitioners occupy a difficult space (a ‘dilemmatic space’), involving: care and protection of people regarded as vulnerable; control of those regarded as dangerous; and empowerment of people regarded as disadvantaged. In social work the ‘scandals’ publicly aired through the media often involve the death or abuse of a child, or serious mistreatment of residents in care facilities. The public inquiries, that both respond to and construct the situations as ‘scandals’, invariably identify systemic, institutional as well as individual failings. The social workers struggling with high caseloads, poor support and lack of resources would vociferously reject being characterised as acting out of personal weakness, greed or folly. To what extent is the ‘remedy’ in these cases to develop and strengthen the moral courage, moral sensitivity and fair-mindedness of individual social workers?
Yet there is no room for complacency. The rate of complaints against individual professionals to the statutory body that regulates social work in England (Health and Care Professions Council, hcpc) is higher for social work than for any of the other 15 health-related professions regulated by hcpc. These complaints come largely from the ‘public’ and relate to cases where social workers are accused of inappropriate intimate relationships with service users, breaches of confidentiality, fraud, serious deceipt, cruel or disrespectful behaviour, for example. Decisions about what sanctions to impose if the accusations are proved are partly framed in terms of character, for example: whether a person of previously good character suffered a one-off lapse that can be explained/excused; whether the misconduct was long-standing and persistent; whether the person displays remorse. What concepts of ‘character’ are at play in these professional conduct hearings and how useful are they in developing a character-based ethics for social work?
Virtues and Contemporary Nursing: something old, something new
Discussion of good character and virtues in nursing is not new, dating back to the 1800’s. Attention to relational aspects of care is evident in early writing and remains central to contemporary nursing. The recent development of empirical and philosophical ethics research and scholarship in nursing provides new insights and illuminates challenges and opportunities for contemporary nurses. Drawing on material from the Nursing Ethics Heritage Collection at the University of Surrey, it will be argued that there is much to be gained from a comparison of early and recent scholarship on character and virtues in nursing.
Corporate Character, Corporate Virtues and Implications for Organisational Practitioners
This paper will argue that context is, if not everything, pretty close to it. In other words, in an organisational context, individual virtuous behaviour is largely dependent upon organisational character. Hence, attention to virtue at the corporate level is vital if we are to provide a comprehensive account of how a character-based ethics will work out in organisations.
The paper begins by summarising previous work on corporate character and corporate virtues. By drawing particularly on the work of Alasdair MacIntyre it then offers a perspective on context-dependant categories of the virtues. Following from this, it provides a philosophically-grounded framework which enables a discussion of which virtues are required for business organisations to qualify as virtuous. It offers a preliminary taxonomy of such corporate virtues and provides a definition of corporate character.
And once we have those pieces in place, we can consider the virtues required of two kinds of practitioners: practitioners engaged in what we will call the core practice of the organisation, and practitioners engaged in the secondary domain-relative practice of making and sustaining the organisation (i.e. managers).
Creating Policy Environments for Practical Wisdom and Role Virtues in Medical Practice
A number of philosophers have recently provided more empirically-informed accounts of virtue and virtue ethics, according to which acting virtuously requires, among other things, the development of certain deliberative strategies to counter common decision-making biases and other countervailing factors which can impede virtuous action. These accounts employ a comprehensive conception of virtuous character-traits, whereby practically intelligent virtues include an awareness of situational factors which conduce to or inhibit virtuous behaviour. In this paper I argue that in the context of professional life, these personal strategies for facilitating virtuous behaviour should be supported by the development of policy environments which assist practitioners acting from the relevant professional dispositions to hit the targets of those virtues.
Taking medical practice as an example, I discuss two important ways in which policymakers can help to successfully enable virtuous practitioner behaviour in professional contexts. First, policymakers should aim to create institutional environments which help to raise practitioners’ awareness of common biases in clinical practice – such as availability bias and confirmation bias in diagnosis – and also help practitioners to avoid biases diverting medical role virtues from their targets. Second, when evaluating an existing or proposed policy which has some independent rationale, policymakers should also consider the position doctors may be put in by this policy – such as whether the policy threatens to undermine therapeutic doctor-patient relationships, along with action from the virtue of medical beneficence. For instance, policies allowing advertising of prescription pharmaceuticals directly to consumers stimulate demand for clinically inappropriate medications, and a significant percentage of doctors working in such institutional environments evidently find it difficult to resist acquiescing to those requests. Yet medical acquiescence in such circumstances is contrary to therapeutic doctor-patient relationships, and to the role virtue of medical beneficence. While policymakers might assist doctors to develop deliberative strategies to better manage such requests, a more defensible policy approach where such requests are highly prevalent might be to abandon altogether a policy of allowing such advertising. I also discuss how similar concerns are raised by certain institutional incentives which have the unintended consequence of encouraging hospitals and doctors to agree to requests from patients’ families to provide interventions to a dying relative, even when those interventions are futile. In considering these examples, I also aim to clarify the links between professional role virtues and properly-oriented practitioner-patient and professional-client relationships.
AFTERWAR: Moral injury, damage, and repair
In this paper I take up the notion of moral injury in war as an important and underappreciated aspect of psychological trauma. In particular, I look at moral wounds and moral repair through the lens of reactive attitudes (ways we hold self and others to account) as developed by P. F. Strawson. My talk draws on my recent book, Afterwar: Healing the Moral Wounds of our Soldiers, and the in-depth interviews in that book with returning service members.
Character Based Business Ethics
Which qualities of character should be fostered in human beings playing business roles? What are the traits that make a good businessperson? The exercise of roles creates special moral demands because roles are socially important (they serve the purpose of the institutions in which they are inserted) and psychologically significant (they contribute to the formation of our identity and moral development). Playing roles changes our moral space in the sense that we learn to be good and find role models in the context of the family and the social, business, and political institutions we inhabit.
I propose to present an outline of a book chapter I am writing for Nancy Snow’s forthcoming “The Oxford Handbook of Virtue” (OUP, 2016). In that chapter, I outline a theory of business in which business ethics is primarily about character and the virtues and vices that are part of it and only secondarily about the acts that character causes – acts that may or may not conform to some principles and rules of action. Thus, I propose a shift in business ethics research from political philosophy to managerial ethics, that is, away from the study of the ways in which theories of justice and democracy evaluate markets and organizational rules and towards the decision-making process at the individual and the organizational level. A theory of business ethics must be, I submit, not only a normative theory about abstract principles and side-constraints but also a theory of the practice of business that is accessible to the people for whom business ethics is not just a subject of study but also a way of life.
What are the excellences of character in the field of business? The answer to this question depends on how we understand the nature of the practice of business and the purpose of business. Virtue scholars in business emphasize the “purposiveness (or ‘teleology’) that defines every human enterprise, including business.” (Solomon 1992: 103) According to Solomon, the goal of business is neither profits nor competition but rather the good life. From this premise, business virtues are defined as “the traits of character that make mutual knowledge or understanding possible.” (1992: 208) The four basic business virtues are, according to Solomon, honesty, fairness, trust, and toughness.
However, there are a number of problems with this and other catalogs of virtues. First, charges of circularity arise because the proponents (besides Solomon, I will discuss the work by Hartman, Moore, and Chun) seem to suggest that our nature or the characteristic function of human beings is what they have assumed to be the virtues in the first place. Second, these catalogs of business virtues imply that business virtues are not different from but rather an application of more general (or ordinary) virtues to the business context because commercial activities are part of social life and so the virtues of ordinary life simply apply to business activities (or, we can say that the business virtues are derived from more general or ordinary virtues). Yet, several commentators argue that competitive markets are hostile to character development. In my presentation, I shall address these objections and sketch the lines along which virtue ethicists in the Aristotelian tradition might proceed in formulating a reply.
A Virtue-based Responsible Conduct of Research (RCR) Curriculum: pilot test results
Ensuring that scientists conduct research responsibly is essential for the advancement of science. Scientific misconduct, ranging from questionable research practices through intentional dishonesty, can set science back by wasting both the time of the scientific community and the limited funding available to support research. As such, one important aspect of scientific training is focused upon helping scientists to conduct their research responsibly, and many funding agencies now explicitly require this for their supported scientists. Unfortunately, the standard methods of teaching responsible conduct of research are known to be imperfect. Drawing on Pennock’s theory of scientific virtues, we are developing an alternative curriculum for training scientists to act responsibly that emphasizes internally derived values rather than externally imposed rules. This approach focuses on the ways that the virtuous characteristics of scientists lead to responsible and exemplary behavior. This virtues-based approach can augment traditional approaches, and we believe that by focusing on the positive roles of virtues, especially through participant-driven discussions and story-telling, responsible conduct of research training will be more engaging, and thus more influential, than simply completing the tasks required to satisfy traditional certification requirements.
For the past two years, we have been pilot-testing elements of a virtues-based approach to RCR training, conducting Toolbox-style discussion sessions with small groups of scientists. Each session focuses on a particular scientific virtue. The participants first respond on a Likert scale to prompts about the role of the topic virtue, and then discuss their thoughts and reactions to those prompts. During these discussions, they explore the roles that the virtue should play in the practice of science. Preliminary results have shown that participants greatly prefer this engaging virtues-based model over the traditional methods of RCR training. If engagement and enjoyment are linked to effectiveness in learning, as we believe it is, this is reason to think a virtues-based approach can enrich standard methods. Results also suggest that all levels of participants, from young graduate students through senior scientists, adjust their views in light of these discussions. Finally, initial impressions also suggest that these discussions enable scientists to better recognize the scientific virtues and equips them with a new conceptual framework that enables them to continue reflection and discussion of these issues with their students, lab groups, and colleagues in ways that can expand the informal relationships of mentoring and collaboration through which much of scientific training informally occurs.
Architecture with Character: teaching ‘professional ethics’ in the Faculty of Architecture in Turkey
In 2012-2013 and 2013-2014 academic years, an elective course called “Professional Ethics in the Built Environment” was designed and taught in the Faculty of Architecture in Izmir Institute of Technology, Turkey which stands as the sole example of its kind in this professional area, in Turkey.
The need for such a subject had arisen because of the frequency of earthquakes which result in large scale loss of life and property such as the 1999 Istanbul earthquake and the 2011 Van earthquake. The fact that some buildings sustained little damage while buildings next to them collapsed entirely points to a lack of professional integrity on part of the construction companies. These striking examples demonstrate how the use of substandard building material to increase profit margins contributes to the humanitarian crises in such devastating earthquakes.
This course was designed as an elective as “professional ethics” was not part of the compulsory curriculum of the university. The content of the elective was designed to foster intellectual and vocational integrity, impartiality, altruism, professional responsibilities and aspirations, setting good examples and included the written ethical codes of conduct of the Institute of American Architects and Turkish Architects. The course was designed as three 50 minute lectures per week for two terms.
In discussions during the lectures, questions such as “how would you feel about designing a prison, a religious building, gas chambers of Nazi Germany, a slaughter house of meat industry, defence complexes” or readings from Aristotle to Theodor Adorno were posed to make students aware of choices that go deeper than putting the right amount of cement, steel or iron while the construction was going on. The course became popular immediately and while 8 to 10 students were choosing most of the other electives, over 50 students were choosing this elective, pointing to a demand in this area.
The course was requested by the Dean, Prof. Dr. M. Gunaydin. The lectures were given by Dr. B. Bridge who had designed a similar course on “Character Education of Teachers”, in the year 2000, who also had published a book in 2003 called “Ethical Values Education” in Turkey. The book and the series of lectures of this course focuses on certain virtues of teachers such as trustworthiness, honesty, compassion, altruism, courage, gratitude, responsibility, fairness, compassion, civic virtues and to teach by example.
Aristotelian Understanding and Character Education in the Practical Professions
One notable aspect of the virtue ethic approach to moral education is that it grounds social justice not in a set of abstract a priori principles or in empirical, often quantifiably justified, consequences; rather it centers upon the lived dispositions of informed characters working together for a common good. The drawbacks of this approach as it concerns institutional education are that: (a) in a pluralistic society there are different and often competing conceptions of the common good and (b) the primary way to avoid akrasia (weakness of will) is typically through private, interpersonal relationships (e.g., family, friendships, religion). For public institutions (non-sectarian rather than state-funded) are limited in their ability to provide concrete opportunities through which student willpower can be strengthened and affirmed through concrete moral choice and just conduct.
Given this context, this paper examines an important chapter in Bk. VI of the Nicomachean Ethics in which Aristotle discusses the often neglected intellectual virtue of sunesis or understanding. The paper argues that sunesis, unlike phronesis, can be cultivated in the classroom and in turn serve as a foundational principle in the character formation of students. Since understanding is a judgment directed at particulars, rather than universals, it is an intuitive knowledge attained through lived experience, i.e., the identification with concrete individuals rather than abstract ideas or principles. In the classroom, such understanding can be informed through case studies that draw out both the objective principles and the individual aspects of the complex situation. What is essential is that students learn not only to analyze the objective principles but also to identify – in a lived experiential way – the proper dispositional attitudes toward the situation (e.g., recognizing the need for sympathy, integrity, etc.). Moreover, because understanding, unlike phronesis, does not involve the will in being directed toward concrete choice, it provides students the space to discern and debate the justice of a situation and the complexities contained therein.
A Study on Cultivation of Moral Character and the Ethics of Teaching for Primary Student Teachers in Taiwan
The proposed paper reports a theoretical analysis and empirical study of the moral character and ethics teaching of pre-elementary school teachers. The paper has three major themes: the first emphasises the current status of teacher education policies about how to cultivate rich educational love in the future teacher and how to cultivate moral character and professionalism of students of teacher education in Taiwan. Unfortunately, teacher education curricula currently has limited credits and time for this, and places more emphasis on fostering teaching skills and professional knowledge of education. Thus, how to cultivate a ‘good teacher’ is worth further study.
Second, to gauge and grasp the current trend in the latest academic research, the paper investigates the so-called “good teacher” described by The Jubilee Centre for Character and Values of Birmingham University in the UK. In particular, it considers the viewpoints expressed by student teachers’ and teacher education institutions’ in the Jubilee Centre ‘Good Teacher’ study and compares them with their equivalents in Taiwan.
Third, the paper will consider moral philosophy and the professional practice of elementary teachers of teacher education with reference to a Chinese cultural and social context, through theoretical and empirical studies, and with particular regard to the ‘Good Teacher’ study. The overall aim will be to provide teacher education with necessary resources and practice guidance for the cultivation of moral character and ethics of teaching for future teachers.
Individual and Institutional Prerequisites of Professional Virtue
Key aspects of good scientific practice are often explicated as a set of ethical and epistemological principles which aim to foster the moral and epistemic integrity of research (Shamoo & Resnik, 2015, 18-9). Virtue accounts in research ethics make use of these principles by relating them to behavioural dispositions of scientists. On this perspective, professional virtue consists in the disposition to act on scientific principles like objectivity and openness. One problem such an account faces is that some norms, which are derived from principles of good scientific practice, are very demanding — for instance the obligation to report supposed cases of scientific misconduct (e.g. data fabrication, data manipulation or plagiarism). Even justified and honest reports involve the risk of severe repercussions for whistleblowers, negative consequences might include the pressure to drop allegations, ostracism from the scientific community, and a reduction in research support (Lubalin & Matheson, 1999). This illustrates that professional virtues are rooted in classical virtues like braveness or conscientiousness much deeper than the discussion in research ethics may indicate.
In this talk I first explore the relation between classical virtues and professional virtues in research ethics with a particular focus on the example of whistleblowing in academia. Then I discuss how virtue ethicists can take a more active role both in the development of academic curricula and the reformation of institutional policies in order to enable and promote virtuous behaviour.
Using Bourdieu’s Field as a Thinking Tool to Understand Character in Teaching
How do teachers (at different career stages) conceptualise teaching and how does this relate to the ‘field’ of education they intend to join or currently work within?
Current discourse in teaching sees teaching as a technical task, that may be done, even without professional qualification, and one that can be monitored and evaluated through proxy measures of accountability such as examination results. This discourse fits with the organisation of the field of education as one of accountability, performativity, and human capital. Here, field is understood, following Bourdieu, as the space within which power is exercised, in relation to the forms of capital possessed by the players, in the field.
Yet there are now moves to reshape the field, centered on the idea that education is more than simply achievement, it is about developing character, both in pupils and in teachers. This is often situated within an Aristotelian frame where the goal of education focuses on the idea of flourishing. How does this fit within the existing field described above?
To answer this question, data from the Good Teacher project will be re-analysed, from two central themes: one is how respondents conceptualise the role of the teacher, by answering the question ‘what kind of a teacher did you want to be?’ and the second is how teachers talk about their work in relation to the field of education, mostly in response to the questions ‘what helps (or hinders) you in being that kind of teacher?’
The data is drawn from semi-structured interviews with teachers at three stages of their careers: 25 beginning new students in ITE, 32 NQTs just about to enter the workplace, and 26 experienced teachers with 5 or more years teaching experience. In addition, there are interviews with 12 Teacher Educators who provide a different perspective when they describe what they think are important qualities for new teachers.
The paper will address the following sub-questions:
- from earlier analysis, it is conjectured that there may be at least four conceptions of teaching evidenced in interviews : technocratic, subject experts, relational and those concerned with a love of learning more generally;
- in Bourdieu’s terminology, are there some teachers who are ‘fish in water’ in the field, or who are at ease and comfortable with the dominant forces at work;
- are there others who are either reluctant compliers, lost souls, or active resistors, or something else;
- are there any differences in either of these aspects (conceptions of teaching and relationship to field) according to career stage;
- and finally, how does the disruption to the field, caused by the language of character, manifest itself in the data.
What Lies Beneath: addressing the empirical gaps in virtue theory, governance and the banking sector
Despite the on-going inquiry into the conduct of senior leaders in banking since the recent economic crisis, this paper argues that there still remains a lack of empirical evidence exploring the role that individual virtues play in maintaining the moral health of banks and other organisations. Consequently, this has also led to the absence of evaluating how virtues are understood by senior leaders and evidence demonstrating how these are subsequently utilised within the context of the boardroom.
To address this gap in knowledge, this paper proposes that the focus of governance needs to be character based, rather than systemic, as the financial market is reliant on the virtues of individuals within the system in order to ensure that it can remain morally self-sustaining and not corrupt.
Although leadership theory development has focussed on integrity, the link to moral behaviour and virtues has not yet been fully established. The race for excellence has been centred on governance mechanisms, encouraging compliant behaviours that fulfil duty and obligation, rather than identifying what constitutes an adequate balance of individuals, backgrounds and lived experiences which form a coherent mutually supportive whole within the boardroom.
The purpose of this paper is to determine how are virtues understood and practiced within the boardroom in banking by applying a MacIntyrian approach to corporate governance that is grounded in positive moral theory and supported by virtue ethics theory. The paper will aim to address the current gaps by focussing on how to examine boardroom practitioners’ individual understanding of virtues. It will seek to determine how the subjective analysis of observations and recording of dialogue within the boardroom can be interpreted in order to assess how virtues are used to navigate through the moral mazes contained within current business challenges.
This paper will help establish a method for identifying an appropriate set of corporate virtues based on this evidence and propose how to channel virtues within governance structures through phronesis, incorporating how to strike the right balance between virtues. It will work towards proposing how these can be demonstrated in order to create a culture for moral development within the banking profession, radiating from board-level behaviours, rather than relying on systemic controls. This will help identify a tool for reviewing boardroom practice that will contribute to understanding the impact of virtues within social auditing.
Constructions of a ‘Good’ Teacher/Student: an exploration of character traits in Kings Langley School
This paper revolves around an institution-focused exploratory work, which was undertaken as part of the school’s ongoing work on situating character development at the core of its school improvement agenda. Following Jubilee Centre’s research on The Good Teacher (2015), we wanted to examine the meanings teachers and students within KLS attached to a good teacher and student. Specifically, we were interested in the character traits that a sample of teachers and students conceptualise as essential to professional practice and students’ own academic work. Thus, we aimed to use this exploratory inquiry to provide a basis for institution-wide reflections and discussions on why character development matters in a performative policy climate and to frame whole-school professional development initiatives on character education.
Drawing on a mixture of unstructured interviews with selected teachers (15) and students (30), group work with 70 teachers and 45 students, questionnaire with 45 teachers and 115 students and self-reflective exercises with 30 teachers, our initial analysis reveals that both teachers and students tended to put a high premium on love of learning, patience and leadership as key character strengths of a good teacher. In a similar vein, students’ identified a willingness to learn, perseverance, being organised and hardworking as important character traits of a good student. Taken together, these initial insights raise some important questions about the expectations teachers and students have and how we might incorporate students into our self-evaluation processes more effectively.
The Structure of Business Virtues
Various attempts have been made to measure virtue in an organisational context through the development of scales focusing on organisational, team and individual virtues (Cameron et al., 2004, 2011; Chun, 2005; Libby and Thorne, 2007; Kaptein 2008; Palanski et al., 2011; Rego et al. 2013, 2015; Shanahan and Hyman, 2003). However, limited work has taken place to validate the scales of individual virtue. No published studies attempt to validate Libby and Thorne’s (2007) scale and the only study that attempts to validate Shanahan and Hyman’s (2003) Virtue Ethics Scale concluded that it could not support it being used or developed any further (Dawson, 2015).
The lack of validation for these scales adds to existing concerns about the theoretical grounding of virtue scales more generally (Bright et al. 2014). Scales are being questioned because their development processes take place on an ad hoc basis drawing items from a range of literature with little regard to whether their origins are compatible. Following these concerns suggests that when scales of individual virtue are developed they need to be grounded in appropriate theory, links to related constructs need to be clearly specified, items need to be appropriate to context, and the scale items need to use language that will be understood by respondents (Dawson, 2015).
In the context of a wider project that takes a pluralistic view of virtue following Swanton (2003), this paper presents a study that identifies virtues in a business context and in the language of business people. Interviews with 58 employees across 16 stores of a leading UK groceries retailer utilised a methodology established by Crockett (2005), Moore (2012) and Fernando and Moore (2015) to identify what they perceived to be good management. In line with a pluralistic approach to virtue interviewees were asked to describe a good manager from three perspectives, being asked what marked out their manager as excellent (MacIntyre, 1985, 1988), successful (Driver, 2001) and admirable (Slote, 1996).
The findings reflect those of Whetstone (2003) who provides examples of how virtue language displays itself in a business and distinguishes between virtues that relate to being, behaviour and results. The analysis goes on to examine to what extent the items identified can be taken to constitute virtues in themselves, and propose a structure for the business virtues. It is argued this structure will provide an appropriate foundation for the development of a scale of individual virtues.
Amplification of Risk in Mental Health Risk Assessment
This presentation discusses how UK mental health nurses’ concern of experiencing moral indignation (e.g. outrage provoked by perceived unjust behaviours) may inadvertently increase bias in determining service users’ risk to self and others. Concern of moral indignation could lead to more restrictive practices within risk management as the assessment indicates to the service user being of more risk (e.g. of suicide or assault) than actually known.
Reduced service user involvement in assessment potentially amplifies risks by nurses erring on the side of caution as there is tendency to rely on risk assessing instruments evidencing factors that increase risk rather than its reduction. Thereafter, nurses could be reluctant to involve service user fearing moral indignation either from the service user or self-imposed as risk interventions become characteristic of social control.
Apprehension of public moral indignation could equally influence nurses to perceive more risk especially during uncertainty in what risks are and how these are occurring. Potentially assessment results in an increase of risks to allow for safety options perhaps otherwise restricted by budgetary constraints, e.g. hospital admission. The presentation will conclude that concern for moral indignation may increase possible deceptive practice of assuming increased risks and being more restrictive to reduce risks. Alternatively the collaborative practice of positive risk taking has benefits whereby care is seen through a lens of coping with uncertainty in life, a challenge for both nurses and service users, and might be reduced by there being transparency of apprehension (on risks) between both parties.
The Role and Significance of the Quality of their Professionalism and Decision-Making of Doctors
Whilst character development and the virtues never has been explicit in any UK postgraduate medical curriculum, we have been exploring since 2005 the role and significance of the doctor’s character in developing the thinking surgeon (de Cossart and Fish, 2005) and the wise doctor (Fish and de Cossart, 2007). We are thus heartened by the main recommendations of Arthur et al, 2015.
By contrast to the work of the Jubilee Centre about defining, developing and assessing the quality of character and the virtuous dispositions of learners in schools and the professions, our work begins from the demands on doctors of practice. From this we have theorised the support needed from postgraduate medical education to develop and strengthen doctors’ capacity for living their aspirations to be a good doctor.
As professional practitioners, one in surgery and medicine, and the other in medical and teacher education, we offer the argument for starting from practice in developing new resources for the education of practicing professionals.
- There is already in medical practice a recognition that the role and significance of the quality of character is central to the practice of a doctor.
- That particularly it is located in the quality of professionalism and is a major determinant of the quality of thinking, decision-making and judgement.
- That currently such character education and development is not explicit in any postgraduate medical curriculum (for all doctors who are supervisees for the first 6 – 12 years of their career and follow one of 99 prescribed independent curricula, depending on specialty).
- That there needs to be a newly developed core curriculum that attends to the whole ontological education of doctors and its continuity and progression.
- Our current module for supervisors, Medical Supervision Matters Series (Fish et al, 2015a,b,and c), has been offering this and the processes and methods we have used have resonated strongly with all we have taught.
- That during this module we have also attended to the inevitable calls for the assessment of such quality by exploring how to evidence good thinking and professionalism in real practice.
Our presentation will extend these points and open them to critique and ask what role this work might have in the future work of the Jubilee Centre.
One ‘Professional Identity’ for Peacekeepers – Reality or Illusion?
The paper considers ‘professional identity’ for peacekeepers from a neo-Aristotelian understanding and points to the implications this reading of identity has for training and education. In that debate, building and acting from a clear sense of professional identity is seen as one central pillar in properly acting upon the responsibilities of one’s professional role, importantly including proper ethical conduct.
This is done against the background that peacekeepers join the peacekeeping profession already having developed a professional identity. Soldiers own a role of combat, police officers one of public order. While their roles are expanded within the peacekeeping field, the paper explores the question whether there can be one separate professional identity as a peacekeeper (only). In this way, it is discussed whether a differentiation between military, police and civilian peacekeepers is required, or whether there is one whole identity that integrates the different backgrounds and influences.
As 12 African nations are part of the top 20 contributing countries sending troops and police officers to UN peace operations, the paper looks specifically into their professional experiences while considering current efforts in peacekeeping training and examining how it meets the requirements of building professional identity as it is here suggested it should be understood.
Treachery! On the distinction between deception and treachery
This paper argues that there is a conceptual distinction between treachery and ruse; virtuous soldiers use ruse, they do not employ treachery. Treachery subverts trust establishing practices that allow for communities to function well; these practices are crucial when knowledge is scarce and danger is ubiquitous. A paradigmatic case of treachery is the donning of the enemy’s uniform. The uniform signals an offer and a demand of trust between members of a collective who cannot be personally acquainted. Soldiers who run to each other’s aid trust that the other is ‘one of us’. Treachery is vicious because it seeks victory by undermining a community’s trust and its ability to flourish. Moreover, treachery also threatens the peace and rest that accompanies trust amongst comrades.
Ruse, however, does not subvert trust establishing practices within a community. When troops lay in ambush or feint a retreat, the enemy soldiers and officers have no reason to expect that this constitutes anything like a promise or the mutual demand and offering of trust. A clever commander may mislead and fool the enemy with false alarms and misinformation, but he does not seek to turn the trust and rest amongst brothers-in-arms into paranoia.
Treachery subverts practices that are essential to preserving community, particularly during conflict. Virtuous soldiers seek to defeat their enemies, not to destroy their common life. Finally, I briefly extend this account to explain how weapons – e.g. poison, stilettos – may be considered ‘treacherous’ by breaching expectations among soldiers.
The Flourishing Employee
Considering some business areas it is found that if it is offered to the employee a high comfort his yield will be as well as high. Otherwise if he is not in a comfortable situation, he will produce less. In this sense, the system of virtues, can be a practical incisive work, able to transform – in long scale – the whole society. The purpose of this research is therefore: 1. put as an example businesses companies and the performance of the employee, e.g. Google Company (carrying out a detailed study, interviews, statistics); 2. analyze what is the anthropological key following which the individual flourish and his job is great; 3. analyze what is really good, developing a refection on happiness. I will start first on the research of Martha Nussbaum, in particular from her text Creating capabilities. The Human Development Approach (Harvard University Press, 2011). Also it is surprising that Nussbaum has strongly criticized the tendency of Virtue Ethics, in “Virtue Ethics. A misleading category?” (The Journal of Ethics, Vol. 3, No. 3 (1999), pp. 163-201). Finally I will describe a singular virtue, the “humility”, perhaps ignored but central not only in a philosophical perspective, but also in a political, sociological, or even more broadly cultural horizon.
Actue Care Nurses’ Perceptions and Responses to Bad Practice: knowing in oneself
Background: Encouragement for nurses to ‘raise concerns’ about unacceptable care is stipulated within the NHS Constitution (2014) Simultaneously, NHS England (2012) ‘6 C’s’ expects good character traits of care, compassion, competence, communication, courage and commitment.
Aims: To report on acute care nurses’ perceptions of bad practice and the degree to which these may relate to individual character, or other sources.
Methods: A small qualitative study based upon Heideggarian phenomenology was conducted between September 2012 and December 2013. Semi-structured interviews of four, voluntary undergraduate acute care nurses undertaking L6 modules enabled participants to ‘think hypothetically’, gaining insights into the ‘world of acute nursing’. Thematic analysis followed.
Results: Nurses differentiate between ‘acceptable’ and ‘bad’ practice according to policies; protocols; compliance with Codes and ‘know in themselves’, appropriate personal moral standards associated with one’s own character. Practitioners appear divided in challenging colleagues’ bad practice, avoid challenging seniors and perceive managers as best placed to prevent ‘ethical drift’ of practice. Education and a culture supporting openness were suggested to reduce malfeasance.
Discussion: Although education concerning the 6C’s is becoming embedded in nurse education, understanding how nurses perceive and respond, psychologically, to unacceptable behaviours is as necessary, because shame and guilt is generated, which may block future learning.
Conclusions: Education about shame may enable challenge, then acceptance of responsibility and subsequent consideration of ethical education. Thus peers may support one another to achieve best practice prior to escalating concerns, and rather than ‘whistleblowing’.
Character in the Professions Online Course
The presentation will provide an overview of the ‘Character in the Professions’ online training courses for medics, lawyers and teachers. A description of how the courses were developed and evaluated against their stated aim to create a teaching intervention for university students, which prioritises the integration of virtue based practice into the legal, medical and teaching professions will be provided. The intervention enabled lawyers, doctors and teachers to explore what it means to be a virtuous professional in their area of expertise.
The presentation will start by highlighting a change, noted in various research (Coulehan, 2005; Bryan and Babelay, 2009; Toon, 2014; Eckles et al., 2005:1145) in the educational emphasis from character to technical competency, in professional training. An explanation of the need to realign training with a focus on core virtues associated with being a ‘good’ professional and explore the rationale for developing a new teaching course underpinned by virtue ethics theory will be given. By describing the process by which the new course for professionals was designed and developed, an explanation of why it was decided that an online course would be most appropriate, highlighting in particular the interactivity and multimedia delivery features of online professional development will be provided.
An overview of the content of the course and key features designed to enhance phronesis in professions will be presented. The key elements of the course will be critically evaluated.
A Virtue-Based Approach to Teaching Person-Centred Nursing Education
Person-centred care puts primary focus on the person rather than a specific health-condition. It emphasizes respect for individual patient preferences and values, responsiveness to patient needs and experience, communication and shared decision making. Teaching skills for person-centred care is an important goal in both medical and nursing education. However, the study of relevant nursing skills and how they are learned seems surprisingly incomplete. In nursing ethics, person-centred care may be conceptualised through nursing principles and codes, but translating these into trainable skills is a task that arguably requires a virtue-ethics approach. The aim of our paper is to address these shortcomings from the perspective of character and virtue in nursing by asking: What are the most important professional virtues and capabilities for person-centred care, and how can they be fostered within nursing education programmes?
We argue that five virtues are directly relevant: Empathy, respect, equal treatment, tolerance and the Aristotelian virtue of „friendliness“. We analyse each of these virtues based on the Aristotelian doctrine of the mean, mapping relevant emotions, perceptive skills and professional behaviours on a spectrum between vices of excess and deficiency. Our analysis incorporates the concept of phronesis and draws out its implications for both practical and discursive professional skills, including critical reflection on one‘s own professional practice. Based on this analysis, we suggest a framework for teaching skills for person-centred care in nursing education, and present preliminary data assessing its trial-implementation in the Nursing Programme at the University of Akureyri.
Reviewing the Responsibility Conduct of Research (RCR) Literature from a Scientific Virtue Perspective
Responsible conduct of research has been scrutinized in the scientific literature with varying intensity for 40 years. The need for the training is not in question—both the National Science Foundation and the National Institute of Health require it for all recipients of their funding. News agencies cover instances of scientific misconduct regularly, and many in the scientific community are calling for improved methods for RCR training. Many of the criticisms in this literature focus on the flaws in the way RCR training is typically approached, with further worries about the efficacy of such training. Concerns include the short term and long term effects of the training, the sorts of understanding imparted by RCR courses, and whose responsibility it is to do this training when time and energy are of limited supply.
We offer a review of this literature from a philosophical point of view, employing a theoretical framework based on Pennock’s theory of scientific virtues. What we find are common themes regarding what counts as misconduct, how RCR training is meant to address this, whether case studies and textbooks are effective and, if so, how does one measure such effectiveness. Our review not only examines these themes as they are presented in the literature, but also offers a framework for seeing these issues in a new light. Our approach aims to move from the legalistic model currently employed toward one in which the character traits, or ‘virtues’, that lead to exemplary science are placed front and center. By inculcating virtues such as curiosity, humility to evidence, perseverance, and others, we offer a new way of approaching RCR concerns and training that is both responsive to the current literature and able to offer critiques that lend an explicative voice to some of the more nascent and abstract concerns that some are beginning to raise. By tapping into the inherent motivations typical of scientists and emphasizing the nature of exemplary scientific behavior, we believe we can develop the means for deeper, longer lasting effects as well as a more coherent understanding of what RCR is and its role in the scientific community.
Military Officer Training Assisted by Neuroscientific Insights into Virtue
Can we identify the neural bases of virtue? And would such knowledge have practical applications? Could it assist in the training and development of virtue?
All second year officer cadets at the Australian Defence Forces Academy (ADFA) in Canberra now receive explicit virtue training via a case studies approach. Highly practical insights, drawn from my investigations into the neural bases of virtue conducted through an Aristotelian lens, are scaffolded into the program. Just as knowledge of phonics can help in reading for meaning, knowledge of brain mechanisms can assist self-management: for example, we become more aware of habits of attention, desires, and our emotional example.
This content includes an understanding of the role of virtues in the character of an effective leader, and reflection on the complementary character of the cardinal virtues: how they operate in concert but that each is necessary, and how they distinctively relate to motivation and to the emotional management of desires and responses to difficulties. We demonstrate that virtue-based character development complements static classifications of character such as DiSC as well as the core ADFA values. We consider the foundational significance of justice, and the priority of personal goal setting and ongoing monitoring. A detailed and highly practical instrument of audit of character is included.
Formal and informal student feedback demonstrates the perceived relevance and effectiveness of the program. As a result this program offers a model for possible approaches elsewhere.
What Does Nursing Want from Virtues?
All that is written on the need for virtues in nursing has been written before in moral philosophy without the mention of nursing. So what exactly does nursing want from virtues? The common claim for the use of virtues in nursing is the importance or distinctiveness of their ‘internal aspects’ as good character traits for nursing practice. The internal aspects are able to provide a ‘more person centred’ practical ethics which is important for healthcare and especially nursing. Good character traits are important for morality and nursing practice as they influence perception, feelings, cognition and behaviour. This however still requires at least a unitary comprehensive moral theory and a comprehensive unitary account of nursing, often the two are conflated, which is lacking in all accounts of what nursing wants from virtues. Unfortunately the result is frequently superficial and frustrating discussions of action guidance and action appraisal of nurses. Superficial because these discussions and more have been carried out extensively in moral philosophy and also in psychology. Frustrating because the nursing ethics literature seems to promise to show how a focus on the internal aspects as character traits can clearly relate to nurses work and lives when in fact it doesn’t. It neglects the importance of external aspects and leaves nurses with the somewhat unrealistic ideal that the virtuous nurse will act appropriately in all situations. One positive suggestion following John Doris is that instead of a strong focus on our characters nursing ought to focus on attending to the environment that affects our behaviour. Though Doris may be mistaken about the robustness of character traits a change of focus to the external environment of nursing practice may really help the practice of nursing, however it is defined, and its use of virtues by attending to a realist moral psychology and the difficulties of acting well in practice.
Professional Ethics and Stewardship: what the virtue of charity tells us about business practice
In this paper, I challenge the idea that the virtue of charity is compatible with capitalist market arguing that we can accommodate virtues such as charity in business practice if the context specific to practice feature of virtue is informed by the principle of stewardship. Within the realm of professional ethics, it seems difficult to separate professional practice from ethical practice. And sometimes, therefore, good professional practice is considered tantamount to ethical practice, or ethical practice is reduced to good professional practice, as it is suggested by professional codes of practice. Advocates of virtue ethics hold that virtue ethics is a better candidate for the relationship between professional and ethical practice because virtue ethics can capture the rich phenomenology of our lives. This response does not consider cases where the context of a professional practice might not be compatible with the applied virtue(s) in this profession, such as charity and business. If charity is the transfer from those who have to those who have not on the basis of altruism, and if capitalism is founded on the exchange of goods for profit-making, then I argue charity is not compatible with the idea of the capitalist market. I propose that business practice can maintain its links with charity, if advocates of the capitalist market accept the principle of stewardship. According to this principle, corporations see themselves as stewards of people’s wealth and they undertake the obligation to take care of it that is, to invest for the benefit of all stakeholders.
Improving the Character and Virtue in the United States Army Profession
The hallmark of a good army is one that is disciplined. However, is being disciplined, or rule following, enough? We argue that it is insufficient for the Army to be concerned only with disciplined leaders and soldiers. It can, and must, work towards improving the moral character of its future leaders and develop them in to moral agents so that they choose to make moral decisions not just follow rules.
The “Kill Team”, Blackhearts Platoon, and Abu Ghraib. These incidences evoke images of U.S. soldiers committing terrible crimes. Instead of merely giving lip service for why violations of ethics pervade our profession, we should reexamine the ways we think about the moral education of all soldiers. We should treat moral education as education and not simply training. Aristotelian virtue ethics must be the foundation of that moral education in order for all soldiers to develop phronesis. That moral education starts at the United States Military Academy at West Point.
The changes we recommend will require attention to the overarching education of the soldier as a moral agent. Moral education must first train, then educate soldiers to a point where they are then able to choose right actions for themselves and act out of respect for the professional ethic. To develop these dispositions of moral responsibility, we need to take new approaches to learning by encouraging full-scale debates about moral issues (a dialectical method) to allow soldiers to question and improve their capacity for dialogue. Soldiers should be able to debate about cases and historical examples of moral violations and moral exemplars. The most important change we need to make will be to assign cadets at West Point moral mentors at various stages of their collegiate career. The moral mentors would be moral exemplars that come in two forms: faculty mentors and peer mentors. These changes to the military moral education program will benefit the military in two ways: collectively decreasing the occurrence of moral failures, and individually fostering greater resiliency against moral tragedy by appropriating soldier’s morals within the greater army ethic.
The Scientific Virtues: results of an interdisciplinary study
Within the scientific community, the professional research values of working scientists, and especially the character virtues of the most exemplary scientists, become the foundation for the practice of scientific research in all fields. Professional ethical virtues affect the way that scientists think about each other and their work as well as non-scientific issues. But despite the importance of these values, there are many unanswered questions about them. What are the normative virtues that are taken to constitute the scientific character? Do all scientists share a common conception of scientific virtue or are there significant differences between disciplines? How are normative virtues transmitted and instilled by the scientific community?
Drawing on philosophy of science and virtue theory, we have developed a philosophical account of scientific virtue, but we are also interested in how a priori accounts relate to the actual value perceptions of working researchers. We hypothesize that that scientists do share a tacit conception of the virtues that constitute the ideals of the scientific character, but that they do not typically come to understand these by formal means. Rather, they primarily absorb these through mentoring relationships with senior scientists who pass them on by example or through anecdotes about other researchers who are seen as exemplifying one or another aspect of scientific virtue.
To explore scientists’ own thinking about the guiding purpose of science and the virtues and values that are essential to the practice of science, the Scientific Virtues Project surveyed a random sample of 500 exemplary scientists as reflected by membership in the National Academies and other major disciplinary honors and a second group of junior scientists. This study provides the first systematic survey of the values that define what it means to be a scientist since Robert Merton’s seminal work in the 1940s and 50s. This presentation will discuss the goals of and theoretical background to our national study, some of its major results, and the two decades of philosophical, historical and sociological research that led up to it.
The Phronesis Project
The calls for change in health care systems have strikingly similar themes: they call for a culture of compassion, other-centeredness and self-awareness, relationality and collaboration, teamwork, embracing complexity, applying knowledge to discern the right action, and a re-focusing on the greater good. Wisdom researcher Monika Ardelt describes characteristics of wise persons as understanding the deeper meaning of things, knowing the limits of knowledge, tolerating ambiguity, engaging in reflective and self-reflective thinking, showing compassion and sympathy toward others, capacity to be other-centered and an overall focus on the greater good.
This paper will describe a longitudinal professional formation curriculum at the University of Virginia organized around the conceptual framework of wisdom, and centered on a 4 year long patient relationship, with the educational goal of fostering the capacity for wisdom development in the medical student, setting the stage for wisdom development throughout their careers.
This project, called the Phronesis project, began in 2014, with a cohort of 12 students enrolled each year. Students are chosen randomly from a volunteer cohort of over 40 students who wish to participate. Each student is matched with an adult and a pediatric patient for their four years, and the students participate in a longitudinal curriculum focused on developing capacity for wisdom formation. The curriculum is seminar based, and linked with specific patient-student interactions (for example: narrative interviews, house calls, advocacy for an identified needed program or benefit on behalf of their patient, health goal setting and behavior change, re-designing a part of the health system to be more patient centered based on experience of accompanying their patient on visits). Curricular elements track with elements for wisdom in Ardelt’s model: reflective practice, compassion, and the cognitive capacity to discern meaning, tolerate ambiguity, notice the limits of knowledge, embrace complexity, make choices in the face of conflicting values, apply expert knowledge toward right action, and focus on the greater good. Students learn habits of mindfulness, fostering positive emotion, empathy, compassion, use of narrative, and advocacy.
Evaluation includes qualitative interviews, narratives, patient-level outcomes of health goals, and student surveys comparing Phronesis students to their non-participating peers.(3-D wisdom scale, Connor-Davidson Resilience scale, Tolerance for Ambiguity scale, the PERMA wellbeing survey, the Maslach burnout inventory). By June 2016 researchers will have analyzed two years of survey data and qualitative interviews from two cohorts of Phronesis students.
Work, Virtue and Guaranteed Income
Against the school of scientific management which holds that workflow should be partitioned, closely monitored and incentivized for the sake of productivity, recent research in management theory emphasizes that employees are more effectively engaged when they are able both to understand that their work fits within a broadly envisioned good and to make decisions about how to do their work in such a way that supports this good. In this talk, I argue that this view can be supported by a virtue-based account of work as a practice with internal goods that helps to realize the common good and that requires the exercise of practical wisdom. I argue that work, therefore, includes a family of practices which should be understood as broader than paid employment. Recognizing that work is broader than paid employment, I argue that a society that wishes to promote work will require a system of support for those whose work is unwaged and I argue that this system is best realized by some kind of universal guaranteed income. While I briefly consider some of the economic arguments in favour of this proposal, I principally focus on responding to one of the chief ethical challenges to a guaranteed income: the reciprocity objection holds that it is unjust for one group (i.e., wage earners or owners of capital) to support another group (i.e., the unemployed) that does not, in turn, reciprocate that support somehow. An advantage of the virtue-based account of work is that it helps to respond to this kind of objection by showing that unwaged work can support the common good and thus represent a legitimate reciprocation of the material aid given through a guaranteed income scheme.
Fostering Professional Virtue through Action Research
There are two popular ideas in teacher education whose interconnections have not been explored in much detail. The first is the idea that teachers, in order to be good teachers, should be critical of their own work by conducting (action) research themselves. The second idea is that teachers, in order to be good teachers, should develop moral and intellectual virtues, through e.g. habituation, dialogue and coaching. When we combine these ideas, we get a picture of teachers as reflective and developing professionals who are ideally in charge of teaching, treated as a moral practice.
The relationship between doing action research and developing moral character has not received a lot of attention either in theory or practice (an exception is Eikeland, 2008). Banks (2016) discusses what it means for a professional researchers to be virtuous, but does not focus on professional teachers who critically investigate their own practice. Previously, I have argued that conducting action research can lead to the development of teachers’ practical wisdom and, in turn, to the development of students’ character (Sanderse, 2015). However, I did not give many clues about what this kind of action research looks like. If teachers can use action research to develop as virtuous professionals, what kind of action research should this be?
To answer the second question, I will describe a number of small-scale, design-based action research projects about moral and character education that have been carried out over the last two years by several Dutch teacher educators, often in collaboration with secondary school teachers or pre-service teachers. The action researchers designed, implemented and evaluated didactical interventions that aimed at promoting teachers’ own character development (e.g. through a moral self-reflection tool) or students’ moral virtues in secondary schools (e.g. through lessons on recognising virtues in literary texts), or both.
By drawing on these projects, I offer concrete examples of how teachers can go about inquiring into the moral dimensions of their practices, and I will discuss several factors that supported or hindered its implementation. In addition, I will evaluate the worth of action research by comparing it to the ‘standard’ approach, where social scientists do the research and teachers facilitate the implementation of the intervention. One of the conclusions is that action research about moral issues is an important tool to establish virtue and character not only on a theoretical but on the institutional level too (Walker, Roberts, and Kristjánsson, 2015).
Developing Character and Virtue in Professional Practitioners
It is easy to approximate honesty, trustworthiness, kindness and compassion in environments where those attributes are permitted to flourish. True character, so popular psychology tells us, is only revealed in challenging situations. This might explain why we so admire those who are tested and not found wanting. People who have shown unwavering courage in the face of adversity are celebrated because they stand up for what they believe and act consistent with those beliefs in difficult circumstances. We typically link their successes to their strength of character.
While the stories of our heroes might be thought to indicate the existence and value of character, situationists in moral psychology might say that (because our heroes number so few) this is more indicative of the limited power of character to guide ethical behaviour for most people in most situations including, importantly, work in the professions. Far from undermining the idea of character and virtue, the situationists work in moral psychology provides clues about developing character and virtue.
Work in the professions often challenges everyday approximations of character and virtue which indicates a need to strengthen desirable characteristics for practitioners. In this presentation I shall argue for combing empirical findings from situationists with MacIntyre’s requirement for virtuous institutions and Aristotle’s ideas on habituation. Situationist perspectives are easily reconciled with MacIntyre’s requirement as both recognize the value of providing environments that support ethical practice – for MacIntyre it is the institutions that allow practices and therefore the virtues to flourish; for the situationists it is the situation that provides the impetus for moral behaviour. For extreme situationists (those who deny the existence of character), manipulating the environment so that right rather than wrong action is facilitated would be of itself sufficient. But therein lie two problems. The first is the unpredictability problem; the second, the transferability problem.
I shall argue that both of these problems can be overcome by structuring situtaional arrangements to i) encourage habituation of professionally relevant characteristics associated with right action and ii) enable expression of those same characteristics in unfamiliar and in unpredictable situations. This approach allows for the development of a minimum threshold of expected professional behaviour for all, while leaving scope for those who wish to develop further their character and the virtues associated with their profession.
Eudaimonia and Professional Roles
Eudaimonism is the view that the virtues tend to benefit their possessors, and in this paper I outline and defend a Eudaimonist conception of the ethics of professional roles. While eudaimonism is often regarded as an attractive position in moral philosophy more generally, it seems poorly placed to adequately account for professional ethics because, as Hursthouse (2007) says, “role obligations” sometimes require us “to do something contrary to… virtue”. However, I contend that eudaimonism can meet this challenge, as well as a host of others, including Hurka’s (2003) charge of egoism, and the challenge from pluralistic alternatives, such as those offered by Swanton (2007) and Sandler (2009).
Education not Regulation: why you can’t regulate for virtuous compassion
In the aftermath of the scandal of poor care at Mid Staffs and the Francis reports that followed, there were calls for more compassion in nursing. The Prime Minister wanted to reward it with increased pay, and the Government nursing strategy is centred around it as one of the ubiquitous 6Cs. As well as renewed interest in education in the virtues in general and compassion in particular, there has also been interest in regulation for compassion, and for the first time the word appeared in the UK regulators code in 2015.
This paper argues that any attempt to regulate for compassion is misguided, and three arguments will be presented. First there is a mismatch between ethical aspirational codes and quasi-legal conduct codes. Virtuous compassionate practice is a feature of aspirational codes but not conduct codes which are designed to protect the public from not-good-enough nurses rather than require good nursing. This distinction survives the conflation of the two types of code within regulatory the NMC code
Second, compassion requires an emotional response and this cannot be under conscious control. Patients report that small acts of kindness are perceived as compassionate, but I argue that they need not be. Education and regulation focussing on these behaviours rather than their motivation promotes acts that look like compassion rather than fully compassionate acts. People cannot be required to be emotional and you cannot make people be what they are not. You can make people write with their left hand but this doesn’t make them left handed.
Thirdly, it has been argued that requiring compassion in regulation simply does not work. It promotes faux compassion of the sort which, it is claimed, is similar to the forced bonhomie of the coffee ship waitress. This has the potential of harming professionals who are forced to have a disconnection between how they feel and how they act, and also promotes cynicism in patients who believe that professionals behave in the prescribed way just because they have to.
In the UK the word compassion is found only in regulatory code written by the nursing and midwifery regulator. Its inclusion is in response to severe failures in nursing practice but is ill considered and incoherent and should be removed when the code is next reviewed.
The Institutional Framework of Professional Virtue
The suggestion that professionals need to exhibit central character virtues such as for example honesty and integrity is gaining in support because of a growing understanding that quality of professional work requires conscientious practice of professionals. The aim here is to show that the demand for professional virtue only makes sense, if professionals are provided with the organisational and institutional room to manoeuvre necessary for the exercise of such virtues.
Traditionally, professions are characterised by having a privileged status tied to requirements of a practical and theoretical expertise, abstract knowledge and a particular form of organisation and regulation, but this characterisation cannot alone justify the special privileges and duties of professions. We thus need the additional criterion that professionals are responsible for and manage central ethical goods as for example justice, health, care, and education, which explains why moral qualities are central to any adequate professional practice – they are needed in order to understand and manage such ethical goods.
In this talk, it will be argued that this intimate connection between ethical goods and professions also provides a reason for understanding the moral qualities of professionals on an Aristotelian conception of virtue, as character traits involving moral reason or phronesis, because management of ethical goods in practice necessary involves good habits of action, rightly formed motivation and reasoned judgement. Moreover, the inclusion of virtue into the practice of professionals raises the question of the organisational and institutional framework necessary for the mature exercise of virtues such as honesty and integrity. In teaching for example, honesty requires amongst other things that the teacher can honestly account for the importance of the subjects raised and the educational methods employed, which requires sufficient room for the teacher to judge what topics and methods are truly relevant and important. In general, in order to exercise the form of reasoning central to the exercise of virtues such as honesty and integrity, there has to be room for professional judgement. In cases where this room is not provided, where the organisations and the institutions constituting the framework of professional practice are made too rigid and too predetermined in detail, it is impossible for professionals to exercise virtue. Thus, the call for development of professional virtues is intimately related to a requirement to supply the professions with frameworks flexible enough to allow for exercise of true moral judgement.
Virtue Ethics for Civil Servants and Politicians
Civil servants, administrators and politicians are expected to behave in a morally acceptable manner. Therefore, the Dutch public administration pays special attention to integrity. In this paper, I will discuss integrity management, virtue ethics and moral leadership. I will conclude with discussing a virtue ethical instrument developed by the Dutch National Integrity Office (BIOS), which ties virtue ethics and moral leadership together.
In the Netherlands, the term ´integrity´ is used in a broad sense. Not only is it an antonym to corruption and other moral wrongdoing, it is also understood in a positive way, relating to moral excellence and exemplary behavior. However, it requires different measures to encourage excellence than to prevent corruption. Two very different strategies emerged in integrity management policies: ‘compliance’ based on rules, and ‘integrity’ based on trust. But prohibitions and control mechanisms seem to be at odds with value-based trust mechanisms. One of the main problems of today is how to combine these two different strategies. Virtue ethics has emerged as a possibly fruitful perspective to address this problem.
Then, I will link virtue ethics to ethical leadership. The latter is an important new theme in integrity management. Unfortunately, leaders underestimate their visibility as a moral role model, and show a lack in moral vocabulary to be able to actively discuss and encourage integrity. A virtue ethical perspective is expected to support top executives and administrators in their role as ethical leaders. BIOS already developed an instrument for the public sector, Integriteit deugt, based on Aristotelian virtue ethics. BIOS is now working on a more accessible adaptation, especially suited to these leaders in the public sector. I will give an outline of this adaptation, the difficulties that we encountered and the questions we are still facing.
Virtue ethics is a promising perspective in the field of integrity management. However, cultivating virtue in experienced and mature professionals is a challenge, particularly when it concerns top executives, politicians and administrators. This paper hopes to provide both theorists and practitioners from different disciplines with new leads to take integrity policies a step further and to learn more about virtue ethics in professional practices.
Virtues for the 21st Century Professional
Open any newspaper and you’ll see that society can use more virtuous behavior. However, virtues are often considered ‘old fashioned’ and professionals do not relate them to their working life. Therefore, the project MijnDeugden.nl (Dutch for MyVirtues.nl) is started in 2014. The goal of this project is to refresh the classic wisdom of virtues and make them fit for our 21th century. The project builds on the well known assumption that virtues can be developed or enhanced by continued practice and have to be applied in daily life. A self-development online portal will be created, that helps individuals to reflect on their own virtuous behaviour. Key module in the portal will be a self-evaluation instrument that (1) includes virtues relevant for the current professional both in content and in language, (2) approaches virtues as a state and not a trait to promote practicing of virtues, (3) is created according to social sciences standards in questionnaire construction (4) is user-friendly to increase the motivation for long term and repeated use. To my opinion such an instrument is missing and will therefore be developed.
This presentation reports about the first phase of the development of a virtues self-evaluation instrument: a search for virtues relevant for the 21th century professional.
I performed a scientific literature search and an online-search, resulting in 14 scientific and five popular virtues lists. From these lists 353 virtue descriptions were drawn. These descriptions were clustered in a process of convergencing and divergencing, following a Grounded theory approach. Using the classifications of Dahlsgaard et al. (2005) and Chun (2005) as a starting point, in the end 17 behavior clusters were identified. Next, these clusters were grouped in six so called ‘Virtues Characters’, reflecting the person you can become by practicing virtues: a Likeable Person, a Brave Person, an Enthusiastic Person, a Careful Person, a Balanced Person and a Thankful Person. Building upon Aristotle’s ‘doctrine of the mean’, preferable you practice all six to become a Beautiful Person. During my presentation I like to discuss the findings so far.
Attachment, Detachment and Indifference in Healthcare
Various scandals and crises in the health service have clearly demonstrated are that good clinical practice cannot exist without compassion and genuine caring; yet clinicians like patients are only human and “cannot bear too much reality”. Lack of compassion and objectification of patients are often used as defences against facing this reality. How can clinicians show the genuine involvement which caring and compassion require without themselves suffering psychological damage in the process? This is an important aspect of phronesis in clinical practice.
I will discuss and evaluate various possible solutions to this problem, drawing on the works of psychologists and philosophers, writers on the medical consultation and also on the thinking of the Balint movement and thinkers who express themselves through literature. I will conclude that successful negotiation of this problem is best achieved not by attempting a middle way between attachment and detachment but rather by cultivating the ability to engage fully and deeply with patients when they are part of the clinicians “here and now” but also to be able to detach completely when the need for this is over. There are similarities between this and the concept of as mindfulness and certain aspects of cognitive psychology, and the place of this and other meditative and cognitive therapy techniques will be considered.
Virtuous Practice in Nursing
Virtue ethics is slowly becoming the moral theory of choice in nursing ethics but nursing itself still seems to be a predominantly rule-and-code based profession. The presentation will focus on the main outcomes of literature review conducted as part of Virtuous Practice in Nursing project by The Jubilee Centre for Character and Virtues. It offers an overview of the state of play of virtue ethics in the current nursing literature.
The project will explore and deepen the understanding of the place of virtues, or character strengths, in nursing and aim to shed a new light on the state of virtue ethics in nursing. A mixed methods approach is adopted to capture the full complexity of the issues involved.
Specific research questions addressed are:
- Which virtues are prized and upheld by the nurses through self-reports?
- Which virtues do they associate with the ideal professional?
- Does virtue ethics provide a suitable theoretical foundation for nursing ethics and education?
- What hinders or helps nurses in exhibiting virtuous practice?
- What recommendations can we give to nursing educators about improving the teaching of professional ethics in the field?
Assessing Character among Junior British Army Officers: an interdisciplinary approach
A defining feature of any profession is its ethic or code of ethics. A professions’ distinctive moral status stems from the societal good it performs and ethical codes are derived from this (Bayles 1988; Oakley and Cocking 2002; Wolfendale 2009). Army officers are key upholders of ethical and professional standards in the British Army and six values (virtues) are prized. These are courage, discipline, respect for others, integrity, loyalty and selfless commitment. Being a youthful and unique profession, the Army needs to regularly reproduce itself by training and developing officer entrants who are recruited from a rapidly changing society. The intensity and duration of recent military operations have been accompanied by changing roles and a number of moral failures such as the case of Baha Mousa who was an Iraqi hotel worker who died in custody following ill-treatment by seven members of the Queens Lancashire Regiment.
The proposed paper will outline a forthcoming study, in collaboration with the British Army, to assess character and virtue among junior Army officers. Participants will be cadets at the Royal Military Academy Sandhurst and serving lieutenants and junior and senior captains. The paper will advocate the use of moral dilemmas in the Intermediate Concept tradition (ICM), developed by Rest, Narvaez, Bebeau and Thoma (1999). Based on USA military versions, four dilemmas have been adapted for the British Army to assess courage, loyalty, respect for others and integrity. Discipline and selfless commitment will be assessed by two other methods: a new self-report measure in the lineage of values in action surveys, together with semi-structured interviews. The study combines the disciplinary approaches of sociology, psychology and philosophy.
How do Social Work Students Develop their Professional Identity?
I am in the final stages of completing my education doctorate concerning ‘How do Social Work Students Develop their Professional Identity’? Within social work education there is a great deal of emphasis placed upon students’ developing their ‘use of self’, and professional identity, particularly within practice learning. Prior to the course, students already have a formed identity, consisting of previous personal experiences, such as many have experience as a service user and work experience. Therefore it is useful to view identity formation as a continuing professional socialisation process, where it is through the interaction with; others (family, friends, peers, practice educators, placement supervisors, tutors and other professionals), the course and the practice learning environment, that students further negotiate their identity and develop their professional social work identity.
By taking a social constructionist approach to this exploration and utilising the work of Bourdieu (1993), Jenkins (2008) theory and also ‘History in Person’, by Holland and Lave (2001), I have interviewed final stage students and their supervisors, where they were asked how students develop their professional social work identity. I have found that this ‘professional identity’ includes students building upon and developing individual qualities such as, integrity, resilience, personal/professional values, and their motivation to become a social worker. I would like to share some of these findings and analysis within the conference