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Blackwell Science, LtdOxford, UKNUPNursing Philosophy1466-7681Blackwell Publishing Ltd 2005

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Book review

Book Review

Book Review

Book review

Book review

Virtue Ethics and Professional Roles

By Justin Oakley and Dean Cocking. Cambridge University

Press, Cambridge, 2001, £40.00 ($70.00) (hardback),

188 pp. ISBN 0-521-79305-X.

This excellent but neglected volume has somethingfor everyone. Both sceptics and proponents of virtueethics (VE) will appreciate the carefully constructedarguments that go to make this book an exemplar ofgood philosophy.

Chapter 1 illustrates just how good the philosophyof this book is as the authors focus on an explorationof the central claims of the major versions of VEinstead of concentrating, as many do, on merely pro-moting VE as an alternative to the putative failuresof Kantian and utilitarian ethics. The account Oakleyand Cocking present here is especially useful insofaras it begins the process (a process that threadsthroughout the remainder of the book) of makingclear the distinctions between VE and those recentagent-centred versions of both Kantianism and utili-tarianism; versions that have been developed as adirect response to the challenge posed by VE. Oakleyand Cocking also offer thoughtful responses to twoparticularly important criticisms of VE and thus, byproviding a well-informed and systematic overview ofVE, this chapter alone makes the book a valuableresource and for aspiring ethicists of any theoreticalpersuasion.

In Chapter 2, the quality of the philosophy contin-ues as they present a sustained set of arguments toshow that recent attempts to infuse Kantianism andutilitarianism with elements of agent-centredness areultimately unconvincing. Using friendship as a para-digm case, they systematically illustrate how allowinga role for dispositions in either Kantianism or utili-tarianism cannot overcome the essential impartialism

of those theories. In other words, their claim is thatneither Kantians nor utilitarians have at their dis-posal reasons for either developing or giving primacyto friendships in the light of the fundamental princi-ple(s) of their theories. This assumes, of course, a viewof friendship as a human good; a view that gainssupport from the idea that, generally speaking,humans do place a high value on friendship.

In Chapter 3, they develop one of the centralnotions of the book which is that VE is ideally suitedto professional roles because of a shared a teleologi-cal orientation; an orientation absent in other theo-ries of ethics. They say

. . . good professional roles must be part of a good profes-

sion, and a good profession . . . is one which involves a com-

mitment to a key human good, a good which plays a crucial

role in enabling us to live a humanly flourishing life. (p. 74)

They are, of course, propounding an Aristotelianversion of VE, and they use medicine and law (andoccasionally, nursing) to illustrate the ways in whichVE and good professional roles relate. In their view,VE guides practice by enabling practitioners to rec-ognize when their actions are likely to corruptrather than promote the goals of their profession. Sofor doctors to practise in ways that do not serve theends of medicine (health, broadly defined) or forlawyers to work for the benefit of individual clientsrather than in ways that contribute to a system ofjustice for all citizens would be to undermine thegoods of the profession, at least from a VE perspec-tive. In contrast, there are pernicious ways in whichdoctors or lawyers can, from either a Kantian orutilitarian orientation, find justification for subvert-ing, or even ignoring, the ends of their chosen pro-fession. The inclusion of examples from law servesto extend the usual ethical concerns of healthcarepractitioners in some interesting ways. While to

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some, the idea that lawyers are in the business ofserving the ends of justice rather than their particu-lar clients might be novel, the discussion of this verypoint brings into sharp relief some of the tensionsbetween ethics and professional roles that fallbeneath the radar of most healthcare practitioners.Although they exist, tensions between meeting theneeds of individuals on the one hand and servingprofessional goals on the other are rarely so explicitfor healthcare professionals. Yet with what might bedescribed as the creeping privatization, managerial-ism, and compartmentalism of healthcare provision,it may well be that such tensions gradually become amore prominent feature of ethical debates withinand about health care.

Readers of this journal might be disappointed tofind nursing figures so little in the book, but manydoctors might similarly be disappointed for it is onlygeneral practitioners and surgeons that are given anyspecific space. However, because this book is moreabout professional roles in general (and for Oakleyand Cocking, nursing clearly fits into this category)rather than about particular professions, there is agreat deal of interest to nurses and to many othergroups involved in work that contributes to humanflourishing.

Some may find the extensive use of footnotesannoying. Personally, I think the authors have madea wise decision in confining the main text to materialthat progresses their arguments because this gives thereader freedom to decide whether or not to follow upthe associated points and issues given space in thefootnotes. In any case, the footnotes provide an excel-lent source of material for the interested reader topursue on specific issues not dealt with in-depth in thetext.

Of course, like all other theoretical positions thereare competing versions of VE. I take Oakley andCocking to subscribe to a moderate version as they

seem to allow that some everyday vices can, in certaincircumstances, become professional virtues. This is amore contentious aspect of VE than these authorsappear to permit despite it being the subject of awhole chapter. And even after rereading the chapterentitled ‘Professional virtues, ordinary vices’ in whichthey set out to do no more than indicate how VEmight address questions around whether or not pro-fessional role requirements might or should outweighthe requirements of ordinary everyday morality, I amstill left unsure about their position. Is there a certainMachiavellian quality in their moderate version ofVE? I’m not sure, certainly they say that ‘

. . .

virtueethics would hold that a lawyer ought not to fulfil therequirements of their role in cases when fulfillingthose requirements would involve gross violations of

justice

’ (p. 121, original emphasis) but, of course, thisleaves open both the idea that there are some ordi-nary vices that can be professional virtues when situ-ated in particular role requirements (a position noteveryone would support or accept) and the meaningof what constitutes a ‘gross violation’ rather than, say,a minor infringement. Perhaps I need to read thischapter again.

This book has its limitations although it doesdeliver on its promise even if one might wish theauthors had extended their intent. It is a thought-provoking and in places a challenging read. The impli-cations of their arguments are myriad and include

inter alia

educational and regulatory issues that can-not be dealt with in such a slim volume; and in anycase, interesting as they are, such issues go wellbeyond the authors’ stated purpose. This book offersa significant contribution to the ethics literature, andplans for a paperback edition will make it availableto a wider audience.

Derek Sellman

University of the West of England