[Professional ethics and institutional ethics: convergence or conflict?]

During the last decades, an important debate about professions in general, and particularly about the medical profession, has taken place. The classic idea that professionals do have a "special mora lity", different from the common morality, which among other things give them legal impunity, came to a head. This causes a great deal of confusion among the professionals, incapable of reacting and redefining precisely their own identity. Some new concepts, like that of "internal morality" of professional activities, made the debate more difficult and confusing. On the other hand, the everyday more powerful influence of free market forces in the health care economy, has made that some decisions taken by health care managers would be considered by physicians as opposed to their professional duties and incompatible with them. This has been the origin of a debate about what is called in North America "New Professionalism". This debate deals with basic questions about the health care professional's identity at the beginning of this new Century.