Instrumentality versus altruism

Sir Sydney Holloway’s article (PJ, August 26, p308) was of real value. It emphasised that one reason for the behaviour of professional healers, presumably including pharmacists, was their own instrumental, egotistical interests, rather than those of their patients: altruism.

A significant portion of the sociological literature of the professions, which fills libraries, has that instrumental focus. However, pharmacists’ literature generally ignores such a viewpoint, preferring to emphasise altruism. Pharmacists and sociologists seldom read each other’s literature.1

It was refreshing and long overdue to see, in literature that many pharmacists read, an article emphasising healers’ instrumental motivations. This sociological mainstream viewpoint possesses great explanatory power. Evidence of this abounds, such as pharmacists being difficult to recruit where they are most needed. Examples are non-teaching hospitals within deprived inner-city areas and superstores during bank holidays.

Perhaps, Mr Holloway’s article “over-eggs the custard”. The selfless motivation of professionals appears virtually dismissed. However, I repeat that I have sympathy with the article’s instrumental emphasis; perhaps it must be stated so bluntly, given such limited space.

But selfless motivation, as a reason for behaviour, is also a long-established thread in sociology.2 Both instrumentality and altruism have been perceived in a Royal Pharmaceutical Society Council meeting.3 Accounts can be written where instrumentality and altruism coexist and even require each other. Sociologists, also, have to earn their bread and desire to gain prestige: understandable, instrumental motives. Sociologists, also, have a code of ethics (British Sociological Association). It makes fascinating reading. That code is connected with various concerns among sociologists; their code, for example, if taken really seriously and applied to ethnographic sociology, has been stated to be more or less unworkable.4

So, pharmacists are now more aware that others consider pharmacists’ ethical code not altruistic but instrumental. What now? Will pharmacists continue to “ignore” the opinion of sociologists? Or, will pharmacists be encouraged to study the sociology in depth? Pharmacists might well then discover many thought-provoking accounts. One is about “post-modernity”, when a plurality of views have their own validity and morality is relativised and marginalised. Hemant Patel, chairman of the pharmacists’ core values working party, observed that the journey to their code of ethics was more important than its destination.

I would welcome a debate in which pharmacists now visit sociology, more seriously, on their journey.

Malcolm Brown
Beccles, Suffolk


1. Brown ME. Self-interest and egotism. Pharm J 1997; 258:408.
2. Weber M. Wirtschaft und Gesellschaft. 4th ed. Tübingen [translated from original German 1922] 1956:1: 1-14.
3. Brown ME. The wagging fingers and candelabra of Lambeth. Pharm J 1997: 259;15.
4. Dingwall R. Ethics and ethnography. Sociol Rev 1980;28:884.
Last updated
The Pharmaceutical Journal, PJ, September 2000;()::DOI:10.1211/PJ.2024.1.208395

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