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A noteworthy book has been written by William Sullivan, PhD, titled Work and Integrity: The Crisis and Promise of Professionalism in America.1 The book presents a sobering indictment and visionary challenge to all professions. It provides an incisive critique of the current failures and challenges to professionalism. Sullivan presents a compelling vision for renewing the social contract for the professions. If moved from vision to action, this work could transform the current crisis of cynicism about the professions into renewal and confidence. All professionals would do well to take this book seriously. To that end, this issue's column is devoted to an interview with Dr Sullivan.
Benner: In some ways, this book seems to be a continued conversation that you and your colleagues began in the 2 influential books Habits of the Heart2 and The Good Society? What connection do you see between those works?
Sullivan: Both books dealt with the cultural and moral resources within American society for justice, community, and greater social solidarity amid pluralism. In Work and Integrity, I argue that a democratic society also draws heavily on the skills and moral sources of the professions. Particularly within a society like ours, in which the pull of utility and instrumental thinking-as in today's ascendant business model for institutions-is so strong, the professions are vital reminders that human welfare ultimately depends upon cultivation of values such as care and responsibility, which cannot be produced by self-interest alone. By focusing on the quality of their craft and the inventiveness of their practice, professionals provide an alternative model of what work can be: a contribution to public value, as well as a source of motivation and deep personal satisfaction.
Benner: Could you explain what you mean by the social contract between the professions and society?
Sullivan: Nursing and medicine have enjoyed positions of honor based on their social contract with the public that they serve. In exchange for bearing social responsibility for safe conduct with those who rely on their services, nurses and physicians (and indeed all professionals) within the bounds of their legal regulations have authority to control who enters their profession, how they are educated, and key aspects of how they conduct their work.
Benner: What do you see as the major...