What’s Ethical, What’s Manditory, What’s Good

The medical profession is bound by all kinds of legalities and protocol. Doctors have to be very careful in how they treat patients and how they record that treatment. They have to operate under the possiblity that anything could go wrong and that they might have to justify their treatments in a law suit, perhaps years after the fact of seeing the patient. They have to take care with what they say and how they say it and know what the medication they administer can do. There are so many restrictions, it’s amazing that doctors have room to function.

Often, they don’t spend a lot of time with patients. If they are busy, they need to see as many people as possible who need their care. It costs a lot to run a medical practice and you need patients to help pay the bills. Also, you want to help the most people you can, so seeing each person for less time would help you do that.

After a certain amount of years in practice, most doctors have seen the typical problems hundreds, maybe thousands of times. They dispense their care with integrity but they do not necessarily need to dwell upon their diagnoses for lengthy amounts of time. Occasionally, when something unusual shows up, or when the situation presented is complex, their attention and their interest might increase. It can be a challenge to address things that you don’t see every day.

So, in a difficult case, is it ethical to keep probing to get an answer to a patient’s problem by ordering test after test after test, even when the tests do not reveal anything definitive? Is it the best policy to tell the patient to get a second opinion or to undergo exploratory procedures which may be dangerous or even life threatening? Is it in the patient’s best interest to probe and poke until you find something that can be described, no matter what the cost in dollars and in discomfort, disruption and pain?

I wouldn’t presume to answer these questions as I do not know about medical ethics. I see that these issues are challenging and the medical profession has its own strict guidelines about what is and is not accepted protocol. From a moral point of view, there is perhaps leeway to discuss an individual doctor’s choice about how to best serve the patient, and certainly there is descretion in what kinds of treatments to offer, depending on the expertise and experience of any individual expert. Again, the overarching protocol of the profession itself helps shape these choices.

If you attempt to look at teaching singing as if it might relate to the medical profession (or any other licensed profession) seeking guidelines, you will find the principles do not align easily.  All of the three American singing teaching organizations (NATS, NYSTA, AATS) have a “Code of Ethics” but no one pays any attention to them and no one ever gets called out for a breach of ethics, so these codes are effectively useless. There are no boards to enforce ethics, no watchdog groups to advise or judge the behavior of teachers. In fact, there isn’t one single thing about teaching singing that could relate to the principles that guide doctors (or almost any other profession).

There are no “consumer rights organizations” for students of singing at a college or in a private practice, either. There is no one to say “Be careful, this teacher has been sanctioned for harming a student’s voice”. There are no groups to do the sanctioning. There is no one to tell you what to expect in singing lessons. The only way to know is to take some and see what happens when you do.

There are no discussions at national conferences about what kind of behavior on the part of a teacher of singing is considered ethical. There are no panels about what should be manitory in singing lessons. There are no clear cut ideas about what during the process of studying singing would be useful or good.

I find this, still, after all these years, utterly amazing.

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3 thoughts on “What’s Ethical, What’s Manditory, What’s Good”

  1. As you know, NYSTA tried to institute standards during the beginning years of the 20th century (NYSTA was called NATS then), which were rejected. I wrote about this, then posted my blog on a singing teacher’s web board a few months ago. The idea was to send up a flag about the idea’s relevance and viability. The vitriol that ensued was striking. The few that do care about standards are in the minority. This issue is a rock that won’t be pushed uphill.

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