Are professional bodies legally able to limit what their members do professionally, o

[Skeptic Ginger]

I don't understand the distinction you're making here.

To me, a license should be contingent on meeting the standards of the profession. Therefore, the candidate's understanding of those standards should be tested as part of determining whether to license them. The two are inseparable.

In some cases it is, like mine. To be an advanced practice licensed nurse I have to be certified in one or more categories of advanced practice.

But keep in mind that certification does not require I be a member of the related professional organizations.

 

[theprestige]

IOW it has nothing to do with the law mandating whatever. Ethics assessments go along with keeping racism, sexism, ableism, whatever out of the rank and file. In the last hospital I worked in (>3 decades ago) it was an annual sensitivity training.

Actually it has a lot to do with the law mandating whatever. Most of the ethical training and certification I undergo every year is precisely because there's a legal mandate and my employer will have legal problems if I don't maintain those legally-mandated ethical standards.

 

[ahhell]

I don't understand the distinction you're making here.

To me, a license should be contingent on meeting the standards of the profession. Therefore, the candidate's understanding of those standards should be tested as part of determining whether to license them. The two are inseparable.

The is largely true.

 

[dirtywick]

well, in the trades a license basically denotes your familiarity with the code requirements for how to perform a task that results in a safe installation. ethics, and even best practices to a certain extent, is beyond the scope of whether or not a particular job is done safely.

obviously i think there's other professions where that would be a lot more pertinent

 

[Puppycow]

I don’t know, if I were a doctor, and if I’d elected to go ahead and assist some execution/s, and if I were debarred as a result, then I imagine (maybe wrongly, not a lawyer) that I’d have grounds not only to challenge that disbarment, but actually to claim sizeable damages.

I'm neither a doctor nor a lawyer, but I think that the term "disbarment" only applies to lawyers. A doctor on the other hand could have his/her license to practice medicine revoked, but I don't think that the AMA has the power to do that.

In that sense, I think the Bar association has more power over lawyers than the AMA does over doctors. A lawyer must be a member of the Bar in good standing to practice law, whereas a doctor need not be a member of the AMA. The later is a purely voluntary organization whereas the former is one that you must be a member of to practice law.

 

[arthwollipot]

I don't understand the distinction you're making here.

To me, a license should be contingent on meeting the standards of the profession. Therefore, the candidate's understanding of those standards should be tested as part of determining whether to license them. The two are inseparable.

So who should set and maintain them, and enforce compliance? The government, or the professional body?

 

[Skeptic Ginger]

Actually it has a lot to do with the law mandating whatever. Most of the ethical training and certification I undergo every year is precisely because there's a legal mandate and my employer will have legal problems if I don't maintain those legally-mandated ethical standards.

Name this "law" and tell us which state and/or country you are in. It would make it easier to discuss if we had the specifics.

 

[Skeptic Ginger]

I'm neither a doctor nor a lawyer, but I think that the term "disbarment" only applies to lawyers. A doctor on the other hand could have his/her license to practice medicine revoked, but I don't think that the AMA has the power to do that.

In that sense, I think the Bar association has more power over lawyers than the AMA does over doctors. A lawyer must be a member of the Bar in good standing to practice law, whereas a doctor need not be a member of the AMA. The later is a purely voluntary organization whereas the former is one that you must be a member of to practice law.

Yes not every doctor is a member of the AMA and yes you need to be a member of the Bar to practice law.

The Bar seems to be the equivalent of medical and nursing boards.

 

[Skeptic Ginger]

So who should set and maintain them, and enforce compliance? The government, or the professional body?

Separate from whatever TP is on about, (I await his answer to my above post), the law doesn't spell out everything there is about the practice of medicine or nursing. Some things are spelled out like who can administer IV meds, or who can prescribe medications, but the bulk of practice falls under what is considered the professional (or community) standard. If a doctor commits malpractice then it might be determined in a lawsuit.

Kevorkian went beyond the standard of 'law' in his case offering patients euthanasia.

The law in this state doesn't limit my prescriptive authority, the board of pharmacy doesn't. I can prescribe whatever my scope of practice allows meaning it is up to me to decide that. The DEA does regulate what I can prescribe in the way of controlled drugs.

 

[Chanakya]

In the US for most licensing it goes something like this.
1. Non-Governmental professional bodies can and do typically have codes of conduct and ethics. They can basically say whatever they want as long as they aren't illegal.

2. I don't think it makes sense to challenge these ethical rules in a court of law. Challenging them at the annual meetings and voting on leadership and what not makes sense.

3. Membership is for the most part voluntarily and not required to work in a profession. If you violate the code of conduct they can censure you or kick you out but the can't take your license. If you're violation of the code of conduct also violates the laws governing your profession, the state board can take your license.

At least in engineering the professional groups have a lot of say in developing standards for licensure but they don't control that is done by state boards who often amend the standards presented by the professional organizations. Teh folks in charge of testing are an NGO so that is outside of the government hands. There's also an NGO that accredits engineering schools.

This applies to engineers and architects, probably to other fields but I can't really be sure. I think the state bars might have more authority over Lawyers than most other Professional Organizations but I could be wrong about that.

In general terms that was informative, thanks. And okay, I understand what you’re saying, that in your opinion turning to the courts of law won’t really be of much use to set right association rules that one doesn’t agree with. ...And agreed, the situation might well be different for different professions.

__________

Incidentally, I was under the impression that most all doctors are members of AMA, but a quick check just now shows that’s not the case. Apparently there’s ~1.1 million doctors in the US, and <0.3 million of them are members of AMA. (Not in the same year, but I don’t suppose a one-year difference will matter much.)

That’s not much at all, at least relative to what I’d imagine it was. Going just by membership numbers, that doesn’t at all look like a monopoly with a stranglehold on the industry. So yeah, going by that as well, I guess it does look likely that they should be free to do their own thing (even if it were the case that in case of a monopoly they’d be open to being challenged in a court of law).

 

[Chanakya]

What do you mean by "legally specified?

You are all being misled by this nonsense the courts can weigh in on the requirements for membership in professional organizations. Chanakya has yet to tell us what specific law he thinks gives the courts jurisdiction over professional organization membership requirements.

Until such a law is forthcoming there is nothing more to discuss. The thread is in peat-repeat mode.


Re abortion, in states where it is still legal most affected worksites like pharmacies and hospitals generally allow an employee to opt out of a specific patient interaction if abortion is involved with the caveat there must be staff that can take over. Otherwise the employee cannot refuse the patient service.

The option for the employee who doesn't like the thought of having to do whatever can opt out of working there. And I don't think the ADA requires the employer find an accommodation for that employee.




Good grief! What is it about "cite the relevant law" that you don't understand? You can't take any agency to court in this case without a specific law you think was violated.

I take it you can't find a relevant law or statute so you are just barreling on with the world rules as you imagine they should be.


Hint: see if the ADA addresses an employee's ethics or position on abortion that an employer or a professional organization has to accommodate. I don't think you'll find it but I'm not going to double check that for you.

Haha, just chill, would you, Skeptic Ginger. I’ve already spelled out why this thread. It’s not to establish some particular conclusion about the question asked, not every internet conversation and not every ISF thread has to be about that. As I've clearly spelled out more than once, this thread is my way of trying to arrive at the answer to the question I’d asked. …Have I ever internet-researched a question to arrive at my own answer? Sure I have. Could I have done that for this question as well? Sure I could. And if I had, then, no matter what the answer, a Yes or No, and given that I’m only casually interested in the question, I’d likely enough not have started this thread at all. As it happens, I chose this route instead, the discussion route, I chose to simply talk about this with people here instead. I don’t see why you’re finding it so very difficult to wrap your head around that.

See my post #60. If you’d just take like two minutes to address what I’d asked there clearly --- no reason why it should take you any longer than that, given you’re already part of the profession --- then that’ll probably of much better help to me in arriving at a provisional answer than this hyper-mode thing you’ve got going! (If you want to, that is. I don’t see why you wouldn’t, but that’s up to you entirely, obviously.)

_____

As far as the last paragraph in your post there, you do realize that the abortion thing I brought up was just a hypothetical, don’t you? I’m not suggesting that AMA actually has any such “ethical” rule.

In any event, why do you even care? As far as this discussion, I mean to say? Your opinion seems to that even if such a monstrous “ethical” rule were to be introduced, they’d still be within their rights to do that --- at least that is what I infer from what you’ve said, even if you’ve not actually said that in so many words. (And they well may be! And, once again, you might consider clearly addressing my post #60, so that I know exactly where you’re coming from on this.)

I did look at the AMA charter thing around the time I started this thread, the huge PDF file thingy they’ve got on their site. I didn’t actually trawl through the thing, but a quick CNTRL-F for “execution” and “capital punishment” threw up zero hits. And yet the AMA does have clearly spelled out “ethical” guidelines about executions, spelled out elsewhere on their website (see the quoted post in my OP). So, my point is, clearly they are able to make up new rules as they go along, so that it isn’t actually inconceivable that the abortion thing might actually come to pass one day, if they managed to get together whatever quorum they need that shares those particular values. (And I mention this last, because you seem interested in specifically the abortion question. But again, I myself had raised it only as a hypothetical.)


__________

eta: Although I guess I'm starting to come around to the view that the law will probably have no reason to bother with AMA rules and guidelines, if only because AMA isn't anywhere near as big a deal as I'd imagined it to be.

When I started this thread I was under the impression that it's what issues doctors' licences: turns out that's not the case, state boards do. I still thought it was very important, both in terms of having most all doctors as members, as well as in terms of how important membership is to doctors' employment and general career prospects: and it turns out neither of those is really true either, and less than a third of all doctors use this place, apparently. So, unlike what I'd started out thinking, AMA's little more than a glorified union-cum-lobby, and actually with less powers than many unions. So, given that it's not that much of a big deal at all, I'm actually starting to agree that there's no reason for the state or the law to much care about what internal rules and guidelines it puts in place.

 

[Chanakya]

I'm neither a doctor nor a lawyer, but I think that the term "disbarment" only applies to lawyers. A doctor on the other hand could have his/her license to practice medicine revoked, but I don't think that the AMA has the power to do that.

In that sense, I think the Bar association has more power over lawyers than the AMA does over doctors. A lawyer must be a member of the Bar in good standing to practice law, whereas a doctor need not be a member of the AMA. The later is a purely voluntary organization whereas the former is one that you must be a member of to practice law.

I just used that term to simply mean kicked off of the place, membership canceled, is all! You’re right, maybe it was the wrong word to use.

eta: Not really, though! Ran a quick google check just now, and the very first hit that shows up there on the search page without actually clicking any further, throws up two meanings, the first specifically relating the law and the Bar, and the second reads “exclude (someone) from something”. Which is the sense I'd used it in. ...But no big deal, I looked that up briefly because I was curious, is all. Happy to use some other word instead, like I said all I meant to convey is in the sense of their membership revoked.

And yes, agreed, it’s probably different for lawyers. (I hadn’t known this when I started this thread, but apparently less than a third of doctors are actually members of AMA, and plus AMA’s function is apparently much less grand, less important, less central to the industry, than I'd imagined back when I started the thread, and far less so than the Bar would be for lawyers, absolutely.) So that, if the Bar thought to include some “ethical” whatsit for lawyers, then I suppose that would be way more problematic than a way less relevant body like the AMA indulging in that sort of thing.

…And absolutely, although what started this, back in the other thread I mean, was a question particularly about AMA; but a wider discussion about other professions as well would be interesting, sure, and entirely on topic as well.

 

[Emily's Cat]

So forget the OP question and make up one of your own then?

Got it.

I genuinely think you're misunderstood the context and intent of my post.

 

[Emily's Cat]

Hmm, okay.

You, Skeptic Ginger, aren’t fazed by my abortion hypothetical, as I’d imagined you’d be. You seem to be implying that even if such monstrous “ethics” were insisted on by AMA, but you’d nevertheless continue to think that they’re perfectly within their rights to do that --- so much so that it would be “absurd” to even think of challenging it.

And Emily’s Cat and ahhell, you disagree with Skeptic Ginger’s apparent humor-trigger, and with what she finds absurd; but the actual substance of her opinion, that both of you seem to agree with.

Well then, given that, and given your own direct first-hand experience of this sort of thing, let me ask all three of you to clarify these specifics for me:

1. Let me just cross-check this one more time: You’re all three unanimous, then, that profession-wide associations, including AMA, are free to devise and to enforce any and every kind of extra-legal “ethical” rule, as long as that doesn’t explicitly break the law? Including, for instance, the abortion thing? Should, for instance, AMA insist that it would be “unethical” and therefore verboten for a doctor to abort a child other than for strictly medical reasons, they they’d be within their rights to kick out doctors for going against that stricture, even if our present laws remain unchanged? You’re sure of this, basis your own personal experience with this sort of thing? (Not doubting you at this point, just trying to make fully sure of where you stand on this.)

Yes. They are free to define what ethical guidelines their members must uphold in order to remain members of that organization. See additional commentary at the bottom of this post.

2. You’re all three agreed, then --- again your personal take, basis your own personal experience --- that it’s such an open-and-shut thing, that it makes no sense to even challenge any such “ethical” rule in a court of law?

Agreed. There is no legal or civil aspect to it which can be challenged, given the already stated requirement that such rules do not break the law themselves.

3. Assuming you’ve all three answered a ‘Yes’ to #2 above, then let me, finally, ask you this: What makes you so sure that a legal challenge of this kind has no reasonable chance of actually working? Is it because you’re actually aware of some such legal challenge actually having been mounted, whether recently or maybe well in the past, and the courts simply threw out the case/s? Is it because you're aware of the laws that apply to this thing, even if sketchily, and basis that arrived at your answer? Or is it simply because you’ve never heard of any such legal challenge ever having been taken to court?

It wouldn't make sense to legally challenge the membership requirements of a private entity. These organizations have high profiles and are associated with professions that require a lot of trust from laypeople who don't have enough knowledge to determine whether or not the professional is doing the right thing on their own - and that makes it more complex in terms of what the general public understands about how it works. But for all intents, taking a legal challenge to the rules for membership in a private organization (when those rules do not violate any laws) would be akin to legally challenging ISF for their membership rules. I mean, you *could* do it if you really wanted to... but it's incredibly unlikely to get you anywhere. Membership rules in a private organization aren't a matter of legality.

I’ll take your word for this, for now --- assuming you’re unanimous about this. Of course, as far as #3, if it is the first answer, then that’ll make it practically watertight, your conclusion, and I'll be happy to embrace it completely. If it's the middle option, then obviously that's less watertight, but I guess I can still accept that provisionally, particularly if you could take the trouble to spell out your working briefly. But if it's simply basis the last option, that is it's just because you've never ever heard of strictures of this kind ever having been challenged in court, just that and nothing else, well then in that case I'd say it remains an open question, as far as I'm concerned.

Let me circle back to item 1. Yes, the AMA could make that rule. And the AMA could kick out any doctor that performs an abortion.

But the AMA doesn't make laws, nor do they enforce laws. And as SG pointed our earlier, the AMA doesn't grant licenses to practice, nor do they have the power to rescind them. There's a pretty reasonable chance that you'd end up with the AMA kicking out a whole lot of doctors who would then go on to continue practicing medicine whether they're members of AMA or not. I think there'd likely be a whole lot of arguments between the state and the AMA on the topic, and depending on the degree of support, AMA might end up backing down.

That said - it's a complicated relationship, and those relationships aren't the same for all professions with these sorts of governing bodies.

For instance... At both the state and federal level, some types of regulatory filings require a signature by an accredited Actuary in good standing. If the filings don't include a signatory with the right credentials, the filing will be rejected. Good standing means that they are a member of the American Academy of Actuaries and have not been censured or reprimanded in a way that precludes them doing work in that practice area. "Big A" Actuary means they've completed the examination process provided by one of the other actuarial organizations (there are several in the US, the biggest being the Society of Actuaries and the Casualty Actuarial Society).

Given the way the current regulations work... if the AAA were to introduce an ethical guidelines that was well beyond the scope of legality, and also rescinded the language allowing for law to take precedent, then it would be hypothetically possible for the AAA to reprimand or censure actuaries in a way that prevented them from complying with their regulatory obligations.

It's highly unlikely to happen though. Were that situation to arise, there'd be a material conflict between regulations and the governing body, which would at a minimum result in some very serious discussions. If the AAA didn't alter their guidelines in order to allow for compliance with regulatory requirements, we could very feasibly end up with a change to the regulations so that signatories were no longer required to be a member of AAA in the first place, but provided some other means for the signatory to demonstrate or affirm competence and requisite expertise. This in turn would weaken the standing of the AAA and that's something they would definitely not want to see happen.

 

[Emily's Cat]

I agree that you are correct when talking about how things currently work, however, I could see a situation where, if membership in an organization was widely required for employment in a field. If that were the case and its possible that membership becomes effectively a requirement to work. If that is the case, I could see a possiblity that there may an avenue for a lawsuit making sense.

Certainly not the case currently as far as I know.

Under what law?

What legal right does the AMA or any other organization have to keep someone from getting a job? Hell, its effectively blacklistnig which is illegal in a many states.

I'd try that or consult a labor attorney a see what they had to say.

Maybe go after them as a monopoly.

To ahhell's point, it's feasible given the right circumstances... but to Skeptic Ginger's (implied) point, it's extremely unlikley.

For an Actuary, being stripped of one's credentials would pretty much make it impossible to find a job in an actuarial role - even if such a role did not require actually signing anything official. It's a small field, and losing credentials would be a huge deal, essentially branding one as being untrustworthy. Realistically, it would probably result in that individual not being able to work in an actuarial or financial or executive role in any medium to large company.

So it's theoretically possible that if the AAA put in place ethical guidelines that created a material conflict between the Academy and the expectations of regulatory bodies... someone could legally challenge the Academy. But again - extremely unlikely, because it would be incredibly bad for the Academy and their role within the field.

And again, this is not necessarily the same situation in other fields, as not all of us are governed and licensed in the same ways. You'd have to take each field independently to assess whether or not it could happen, and whether or not there's any likelihood to it.

 

[Emily's Cat]

Why do you think that should be part of licensing, rather than part of professional standards?

Depends on how specific you're being with the term "license", and whether you're explicitly limiting this to only the practice of medicine.

In order to earn my professional credentials, I had to pass a whole **** ton of exams. Portions of those exams dealt with the ethical obligations of the profession as a whole. The exams are run by one of the actuarial societies recognized in the US.

In order to be part of the American Academy of Actuaries, I am required to have credentials issued by one of the member organizations. Additionally, I'm required to maintain documented continuing education with I submit annually - and part of those continuing education credits are professionalism and ethics.

In order to issue official Actuarial Opinions, or to sign an Actuarial Memorandum, I'm required to be a member of the AAA in good standing - which means I have to be credentialed by one of the societies, be up to date on my CE (including ethics), and to have not been reprimanded or censured within my field.

I don't technically have to have a "license". But for all intents, in order to work as a "big A" Actuary, I have to meet and maintain those requirements - which includes passing exams that include ethical precepts as well as continually engaging with relevant ethical and professional content.

++++++++++++++++++++++++++++++++

I could do work as a "little a" actuary - that is doing work that is actuarial in nature, but in a capacity in which I would not be able to issue official opinions or sign official documents. In that case, however, I would be expected to be performing such work under the direction of a "big A" Actuary.

 

[theprestige]

So who should set and maintain them, and enforce compliance? The government, or the professional body?

Either way is fine with me, in principle. And I still don't understand the distinction you're making. In fact this new question of yours seems like a bit of a non-sequitur.

Instead of this attempt at a Socratic thing, please consider laying out your premises, reasoning, and conclusions all at once.

 

[Emily's Cat]

IOW it has nothing to do with the law mandating whatever. Ethics assessments go along with keeping racism, sexism, ableism, whatever out of the rank and file. In the last hospital I worked in (>3 decades ago) it was an annual sensitivity training.

That's DEI stuff, not medical ethics though. Most of the stuff that ends up going to medical ethics reviews isn't about racism or sexism, it's about the ethics and morality involved in specific medical decisions. They're much more complex topics than DEI stuff.

 

[Skeptic Ginger]

That's DEI stuff, not medical ethics though. Most of the stuff that ends up going to medical ethics reviews isn't about racism or sexism, it's about the ethics and morality involved in specific medical decisions. They're much more complex topics than DEI stuff.

Medical ethics are addressed by the hospital or an employer if the MD is not in independent practice. In independent practice it would be a lawsuit if damage resulted.

I can give you an example. In the hospital I worked in (again decades ago) a married patient was diagnosed with HIV. The doctors didn't think they should inform the guy's wife. The times were when there was a lot of confidentiality re sharing HIV information the doctors didn't understand.

That was clearly an ethics violation and it wasn't a confidentiality issue. You get the patient to inform the wife and if they won't you notify public health who can.

 

[arthwollipot]

Separate from whatever TP is on about, (I await his answer to my above post), the law doesn't spell out everything there is about the practice of medicine or nursing. Some things are spelled out like who can administer IV meds, or who can prescribe medications, but the bulk of practice falls under what is considered the professional (or community) standard. If a doctor commits malpractice then it might be determined in a lawsuit.

Kevorkian went beyond the standard of 'law' in his case offering patients euthanasia.

The law in this state doesn't limit my prescriptive authority, the board of pharmacy doesn't. I can prescribe whatever my scope of practice allows meaning it is up to me to decide that. The DEA does regulate what I can prescribe in the way of controlled drugs.

So correct me if I'm wrong on this. The government permits you to practice*, and the professional body tells you how to practice. Is that a reasonable summation?

*ETA: within the limits of the law, of course.