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Alfred de Grazia:


PUBLIC & REPUBLIC : Political Representation in America



CHAPTER VIII

Part  B


PROFESSIONAL REPRESENTATION


The consignment of special rights in the selection of certain representatives to particular skill groups is an age-old device of representation. Military and Church affairs are two examples of professions to which the question has always been pertinent. There, one contention has held that co-optation from its own elements was the best mode of selecting representatives, even though political power might characterize the positions being filled; another contention has asserted that the selection should be made by the general political power, usually the state, in conformance with its own criteria for selecting representatives. Two considerations require attention in systems of co-optation. Most social groups wish to be governed by persons sharing their characteristics so far as possible. This is especially true of groups possessing high status, for they feel that their social position requires their being led by social equal or superiors. In addition, the specialized nature of the tasks re-enforces clique feelings: an engineer should lead engineers, a lawyer, lawyers, and so forth.

Often specialization is socially recognized. People believe that there are specialized tasks to be performed which have a direct relation to the group. So the specialized representation, undertaken in the name of the society, may become consigned in part or as a whole to the specialized profession. Since groups possessing clique attitudes are quite common, the demand for special treatment in the selection of the representatives who are to govern a group usually outstrips the supply of such representation which the society is willing to grant. Such groups may often have to content themselves with the privilege of being "consulted." Thus American businessmen have demanded often that persons placed in positions of responsibility, many of them having to do with economic matters, be "cleared" by their associations. And the criticisms often voiced against "braintrusters" or "bureaucrats" were based on the feeling that businessmen ought to be represented by men "of their own kind." Though at times the excesses of such demands for "reflective" representation have had to be rejected for more pressing political reasons, nevertheless the selection of any specialist in government is generally accompanied by an examination of the sentiment of the leaders in the field within which the specialist will operate. The wider the sphere of his operations, the broader his constituency, the less force specialism can have in his selection.

However, in at least two fields of American life, considerable autonomy and powers over task affecting the public as a whole have been granted. These are the professions of law and medicine.[20] Both have been seriously affected by the changes of the industrial Revolution and have lost some of their ancient mystical character and prestige. New techniques in competing fields and in their own fields have augmented their own insecurity about their status as well as the public insecurity in regard to them. but in those respects they still have lost not nearly so much of their integral character as have the arts and crafts during the centuries of the development of large-scale trade and commerce. And since both these fields have been concerned with the tribulations of men, they have always been in a superior position for carrying out their political programs.

As has been mentioned before, the use of lawyers in the selection of judges was put forth as a possible representative device by Benjamin Franklin at the Constitutional Convention. The idea was not taken up in the years that followed, and though the Federalist leaders believed that the professions could accomplish their representation through their position of natural leadership (as, in fact, they did), considerable popular feeling against the common law, the lawyers, and the courts was present during the better part of the nineteenth century.

The case of Illinois is typical. The first Illinois constitution of 1818 provided for the legislative appointment of judges and for tenure during good behavior. In 1826, however, the office of Justice of the Peace was established in each country and was made elective, with a four-year term. The second constitution of 1848 abolished the appointment and indefinite tenure of judges. The constitution of 1870, still in effect, brought only the Justices of the Peace out of the elective ranks, making them appointive by the governor (upon the recommendation, however, of the judges of the courts of record in Cook Country, where Chicago is situated). In 1905, elective judges again replaced the Justices of the Peace, and at present all judges are elected.

The most important single influence in enlarging the role of the bar in the selection of judges was the organization of bar associations in the large cities of America after the Civil War. Though the associations worked against a strong current of machine politics, they were able to undo some of the provisions which the direct democrats had established in the first part of the nineteenth century.[21] And in the twentieth century the continuation of their efforts indicates that there is a long-term trend towards the strong influence of the bar in the selection of judges. The most advanced type of bar participation in elections is found in the "Missouri Plan," under which a non-partisan commission submits names from which the governor appoints judges of the appellate courts. The influence of the bar cannot be measured in terms of the state continuation, for thirty-seven states follow the elective principle for most or all of their judges, and the remaining states follow the practice of gubernatorial appointment.[22] The influence must be measured rather in the extent to which the bar associations participate in and turn the course of judicial elections with bar-association recommendations and active campaigning.

In addition to its political campaign activities, the typical bar acts as the disciplinary force of the profession. In Cook Country, for example, the Chicago Bar Association institutes practically all disciplinary proceedings against members of the legal profession, and is the agent of the Illinois Supreme Court in any such action against local lawyers. Although its membership contains at best only a majority of lawyers, the bar association is the strongest collective weapon of the lawyers in the community and consequently speaks with considerable force on behalf of all lawyers. The present movement toward an "integrated" or "inclusive" state bar promises to bring to lawyers greater scope of authority over their own behavior and over matter pertaining especially to their work.[23]

Unlike the bar associations, the medical profession has not participated in political campaigns to a noticeable extent. However, its authority among its members and over professional standards is much more extensive. And its most important organization, the American Medical Association, is more tightly knit and more powerful as an opinion and pressure group than is the American Bar Association. Control over membership in the profession of medicine was exercised at an early date in American history by the first medical societies. In fact, their chief function was that of granting licenses to practice.[24] The early nineteenth century, with its strong egalitarian and individualistic currents, reduced the group powers of the American medical profession to the vanishing point. The societies began to recover strength slowly toward the end of the century. A number of years in advance of the general tendency to give medical associations self-governing powers, a law of North Carolina in 1859 gave the physicians of that state a corporate existence in law. "The association of regularly graduated physicians... is hereby declared to be a body politic and corporate," with "power to appoint the board of medical examiners."[24]

The American Medical Association evolved from a number of these societies that were struggling for corporate recognition within the states. It reached its present form at the end of the nineteenth century. Since then, it has been run continuously by a minority whose representative character, so far as the membership is concerned, has been adequate. Most doctors disliked association politics as much as they disliked engaging in governmental politics, and left matters of A.M.A. policy, organization, and leadership to the active minority. The faction within the association which resented the policies of the leadership never has managed, according to Oliver Garceau's excellent study of A.M.A. politics, to translate its attitudes into action.

Although the A.M.A. has attempted to be the sole judge on all matters affecting health, in recent years it has not been able to monopolize the field. Its state branches ordinarily dominate the state licensing boards, but they cannot prevent special "cults" from receiving licenses in all cases. In the field of group medicine, the A.M.A. has been faced with powerful opposition from organized labor and co-operative associations, as well as from social service experts, and it has been able to conquer unqualifiedly on behalf of its policy of laissez faire in medical care. Its influence in the grading of medical schools, however, is considerable.

The experience of both lawyers and doctors in their respective associations seems to indicate that a limited pluralism does not bring with it a greatly increased participation in the politics of the group. The internal politics of the functional groups in likely to be as boring and distasteful to many of the members as is the politics of the state in traditional form. The satisfaction of belonging to an organization must be considered, but that is a far cry from the type of intense performance that functionalism was supposed to bring to its members according to the more enthusiastic pluralists.

However, it does seem that the leadership in both medical and legal associations is competent for its positions. But here again the limits of vision are the provincial demand of the associations, not the demands or needs of the society as a whole. Representing the membership of the A.M.A. is much different from attempting the representation of the public health, no matter how much the propaganda of the A.M.A. tries to identify the two sets of ends. In this respect, the resemblance to the lobby is marked.

Furthermore, when one considers the vast difference between these two professions and the occupations which take up the lives of most other people, the dangers of extending principles of organization and controls are apparent. The one factor of job mobility alone suffices to set apart the professions from other functional groups, and the experience of state politics shows that the matter of personal mobility is of great import to the growth of a corrupt type of machine control.


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