At 06:38 PM 5/11/01 -0300, Alexandre Fenelon wrote:
>4-As medical care is becoming a commodity, there is a complete pervertion
>of medical practice, since it´s oriented by immediate profits. Off course,
>many (maybe the majority) doctors are aware of the contradiction between
>the patient well being and immediate and monetary gains, but its difficult
>not to follow the "market logic" in a market economy.
Professions emerge as occupational communities, organized explicitly within the realm of work itself rather than in the sphere of consumption. Its basis is the practice of certain esoteric and easily monopolized skills and the use of procedures that by their very nature work most effectively through secrecy and idealization. The experiences of selling of such services and striving to protect their esoteric quality and ideal image give a common basis for an associational group to form; the interests of the members in recognition and prestige motivate them to institutes strong informal and, eventually, formal controls over insiders and to seek to sanction outsiders'; and their resources--skills, techniques and opportunities for playing on laymen's emotions, wealth, and personal connections that can be translated into political influence--enable them to organize an occupational community with strong controls and defenses.
Many of these techniques by which the professions became organized originally and achieved their status were based on mystification and secrecy regarding their real skills and use of the status rather than their technique per se.
A better explanation of the claims of altruistic deeds of ethics is that they are defenses against the potential distrust of the public and those they claim to serve. An occupation that monopolizes an important skill and reserves the right to judge its successes or failures among the community of accepted others can provoke considerable antipathy among those who depend on it.
Moreover, even among the most talented, the outcome is never perfect and mistakes are made. In order to protect themselves against the anger of unsatisfied publics, the occupational groups profess strict standards and enforce them against those who bring the entire group into disrepute.. As Zilboorg puts it, it was the public who created the Hippocratic Oath rather than the doctors themselves."
The Credential Society, Randall Collins.