The Personal in the Professional
Among today’s professions, medicine is generally considered to be the gold standard. Consistent with the high status of the profession, the Hippocratic oath taken by new physicians is generally taken as a model for how professionals should behave.
Clearly inspired by the Greek physician Hippocrates, the oath is almost two and one half millennia old. It’s difficult for us to imagine what medicine was like in the days before modern science and technology—a time without antibiotics, sophisticated surgical tools, or coherent theories of the causes of disease, the variety of treatment, and the range of possible cures. And so, not surprisingly, doctors have recently sought to update the oath—for example, considering the social and financial conditions of the patient, taking into account the patient’s knowledge as well as the doctor’s area of ignorance, and acknowledging the importance of the psychological states of both patients and their families. Click here for a discussion of such tweaks.
But even as the prototypical profession has attempted to incorporate facets of new knowledge and perspectives, another powerful force is at work: the advent of technologies which promise to accomplish the traditional tasks of the physician more competently than does the flesh-and-blood practitioner. Either already in use or on the horizon are surgeries performed by robots, diagnoses executed by computer programs, radiological data interpreted by apps, and numerous other computational innovations whose performances are indistinguishable from or even superior to those of well-trained doctors, armed with their Hippocratic oaths.
Nor is this substitution of the program for the person restricted to the practice of medicine. To be sure, not all professions are as well-delineated as medicine, but as detailed in The Future of the Professions by Richard and Daniel Susskind, and in other contemporary writings, many of the tasks traditionally carried out by lawyers, architects, accountants, and their respective paraprofessionals can now be done more quickly, cheaply, and correctly by machines than human beings. In the profession that I know best—that of educator—there are well-financed efforts to make both instruction and evaluation “teacher-proof.”
Other than expressing nostalgia for the “good old days” or voicing relief that we have transcended “the bad old days,” how should we feel about these trends—trends that there is every reason to expect will continue? One has to be rigid, even doctrinaire, not to be pleased when services can be provided to individuals who previously were not served at all (for example, physical or psychological care for a person who is unable to care for himself) or can be done more swiftly, more accurately, and in a seemingly more disinterested way (for example, when one’s taxes are computed by a well-tuned program).
Yet before celebrating the replacement of the professional person by the practical program, it’s important to take into account two factors. First of all, even the well-planned and well-executed program has been created by human beings. Accordingly, such programs have built into them assumptions and biases which must be recognized and may need to be reformulated—again, by human beings (at least for now).
Rather than eliminating the trained professional altogether, a shift to “computational programs” brings to the fore a new kind of professional: the computer programmer, the individual who handles servers, those who write and rewrite and enforce the rules of the internet and the web. We might say that the qualities of these professional services are only as “good” as the qualities of the professionals who create and regulate their use, and new technologies always bring about new complexities and unintended consequences. Perhaps these new professionals need to develop and promulgate their own versions of a profession-wide code or oath in order to deal with the multitude of moral and ethical quandaries that are bound to arise.
Second, while it is preferable to have some service rather than no service, the absence of a knowledgeable and caring “live” professional has its costs. A trained professional does not simply provide the requested service; she is expected to know the client as an individual, to take into account the larger concerns of the person (even those not directly linked to the requested service), to make broader connections and recommendations, and to exhibit solidarity as one human being responding to another. To capture the recent changes in the Hippocratic oath in a familiar phrase, we should expect that a good professional can “feel our pain”—though of course the professional cannot allow that pain to interfere with the needed service.
Professionals are neither fully replaceable nor completely irreplaceable. Within and across professions, there will be tasks that can and should be carried out in the absence of human beings, as well as those that benefit significantly from a human touch. Also, it may well be the case that some professions are far more dependent on the human interface than are others. For example, most of us care more about personal contact with a social worker than personal contact with an architect or an auditor. By the same token, it is more important for a pre-schooler to spend daily “face time” with a teacher than for a college student to have personal interaction with a teacher of statistics.
Returning to the opening example of the medical profession, it seems clear that every profession needs to rethink its version of the Hippocratic oath and to do so periodically. Such rethinking requires a recognition (and, in most cases, a reaffirmation) of its original set of values—the services that it most urgently and uniquely has performed over the years. In addition, professions must consider the strengths and limitations of the available and foreseeable technologies and participate in meaningful dialogue with those individuals and institutions who have been served by the profession, in order to determine those situations and conditions where the human factor is crucial, as well as those where it is less important, unnecessary, or even counterproductive. The result may well be reconfigured professions and a different professional landscape. I doubt that it will mean the disappearance or the devaluation of the professions altogether.