Professional speech.

AuthorHaupt, Claudia E.
PositionIntroduction through I. Situating Professional Speech, p. 1238-1268

ARTICLE CONTENTS INTRODUCTION I. SITUATING PROFESSIONAL SPEECH A. What Is Professional Speech? 1. The Role of Knowledge Communities 2. Distinguishing Private Speech 3. Distinguishing Government Speech B. Professional Speech in First Amendment Doctrine C. The Commercial Speech Analogy II. THEORIZING PROFESSIONAL SPEECH A. Autonomy Interests 1. Decisional Autonomy Interests 2. Professional Autonomy Interests B. Marketplace Interests C. Democratic Self-Government Interests III. LIMITING PROFESSIONAL SPEECH A. Regulation of the Professions B. Tort Liability 1. Professional Malpractice 2. Informed Consent IV. WHEN PROFESSIONS SPEAK A. Deference to the Professional Standard B. Codification of the Professional Standard C. Compelled Speech Contradicting the Professional Standard CONCLUSION INTRODUCTION

Professionals speak; some speak a lot. Lawyers use verbal communication to exercise their profession. So do psychologists. Medical advice is dispensed via such communication as well. The list goes on. The content of these communications, we intuitively assume, is protected. The scope of protection, however, is elusive. At the same time, the state can regulate the professions. Traditional forms of regulation include licensing requirements, advertising regulations, and the imposition of professional malpractice liability. But new forms of regulation go further: they target the content of the communication between a professional and her client. Sometimes, such regulation aligns with professional insights, but sometimes it contradicts them. The resulting tension between state regulation of the professions and professionals' free speech interests remains underexplored.

Recent cases involving professional speech (1) have made this tension apparent. Can the State of California and the State of New Jersey ban sexual orientation change efforts (SOCE)? (2) Can the State of South Dakota require that abortion providers read to their patients a legislatively drafted statement that does not correspond to the current state of medical science? (3) In other words: do psychologists have a First Amendment right to engage in conversion therapy? Do physicians have a First Amendment right not to be compelled to make state-scripted, erroneous claims about abortion to their patients? These examples represent potential infringements on a professional's right to free speech. But federal appellate courts have taken opposing approaches to indistinguishable questions. (4)

What is strikingly--and perhaps somewhat surprisingly--still absent from the case law and the legal literature is a comprehensive theory of professional speech. (5) The Supreme Court has never identified, with any clear boundaries, the category of professional speech. Nonetheless, it is implicit in a number of decisions involving government-funded speech, (6) commercial speech, (7) and other areas. (8) This Article seeks to fill the lacuna left by courts and scholars by offering an account of the doctrinal and theoretical bases of professional speech and its application to controversial First Amendment questions.

First Amendment protection for professional speech, I argue, rests on distinctive theoretical justifications, and the key to understanding professional speech lies in understanding the character of the so-called "learned" professions. These learned professions, I submit, should be thought of as knowledge communities, that is, communities whose principal raison d'etre is the generation and dissemination of knowledge. (9) Conceptualizing the professions as knowledge communities not only informs the theoretical justifications for First Amendment protection (10) but also the limits of that protection, the permissibility of regulating the professions, and the imposition and extent of tort liability for professional malpractice. (11) Imposing professional malpractice liability has never been found to offend the First Amendment. Why that is so, however, merits further investigation. Conceptualizing the learned professions as knowledge communities guides this undertaking.

Professionals speak not only for themselves but also as members of a learned profession: they "assist[] individuals in making personal choices based on the cumulative knowledge of the profession." (12) The professions as knowledge communities thus function in a way akin to what Paul Horwitz calls "First Amendment institutions." (13) First Amendment scholars concerned with professional speech have hinted at the connection between the professions and institutions (14) but have yet to provide a full explication. This Article takes on that task.

My analysis abuts and engages the emerging institutionalist First Amendment literature. (15) In my account, it is the institutionalization of professional discourse that builds the basis for the knowledge community. The subsequent dissemination of that knowledge within the professional-client relationship ties the individual professional back to the knowledge community. That the individual professionals are bound together by the knowledge community is also the underlying assumption of professional malpractice law, in which the knowledge community's standard of care determines the benchmark against which the individual professional's liability is assessed.

This Article proceeds in four parts. Part I provides a definition of professional speech, with particular attention to the role of the learned professions as knowledge communities. It then situates professional speech in the doctrinal context of the First Amendment. Commentators have analyzed professional speech primarily in relation to--and by analogy with--commercial speech, (16) which has received increasingly robust First Amendment protection. (17) But the underlying comparison, I argue, is tenuous. The speech interests are fundamentally different. The doctrinal fate of professional speech, therefore, ought not to be tied to that of commercial speech.

Part II undertakes a normative defense of First Amendment protection for professional speech. The traditional justifications for speech protection apply in a distinctive fashion to professional speech. Professional speech is unique in the way it implicates the autonomy interests of both the speaker and the listener. I will call "decisional autonomy interests" the interests of the listener who depends on the information provided by a professional to make an informed decision. (18) The professional-client relationship is typically characterized by an asymmetry of knowledge. The client seeks the professional's advice precisely because of this asymmetry. At the same time, the agency of the listener requires that the ultimate decision rest with her. The other autonomy interests are those of the speakers, which I will call "professional autonomy interests." The qualifier "professional" signals that it is not the autonomy interest to freely express one's personal opinions that is at stake--as is the case in most free speech theory--but rather to express one's professional opinion as a member of the knowledge community.

Turning then to marketplace considerations, I argue that the classic notion of a "free trade in ideas" (19) has little purchase as between the professional and the client. The professional does not seek to subject her professional opinion to "the competition of the market" (20) when speaking within the confines of the professional-client relationship. Yet, there is a dimension to the marketplace idea in the professional speech context that is generally underappreciated and comes into relief when the professions are thought of as knowledge communities. Within the discourse of the knowledge community itself--that is, outside the professional-client relationship-a marketplace of ideas exists, which we might call an epistemic marketplace. Professional standards are generated by testing insights in that marketplace. The current state of the knowledge community's discourse provides the foundation for the professional's advice.

Finally, theories of democratic self-government also provide a normative basis for the protection of professional speech. The information that the knowledge community communicates to clients through individual professionals cumulatively enhances the basis upon which public opinion is formed. This is not simply a matter of enabling self-government through ordinary deliberation by adding another opinion to the public discussion. Rather, professionals contribute specialized, technical knowledge to which lay citizens would not otherwise have access. It is precisely in their capacity as members of knowledge communities that professionals enhance the process of self-governance, and so as members of knowledge communities that they should enjoy First Amendment protection.

Part III considers the appropriate limits on professional speech. It interrogates the extent to which the state may regulate the professions' educational and knowledge standards. It also considers the interplay between the First Amendment and tort liability for professional malpractice. In order to avoid malpractice liability, professionals must exercise their profession according to the degree and skill of a well-qualified professional. For example, the Restatement (Third) of the Law Governing Lawyers states, "[A] lawyer who owes a duty of care must exercise the competence and diligence normally exercised by lawyers in similar circumstances." (21) It is thus the knowledge community that determines the standard of care. This Part engages contemporary tort scholarship that incorporates this insight by focusing on the profession's distinctive expertise. (22) This emerging approach mirrors my concern with granting deference to the knowledge community's insights.

The extent of tort liability, I argue, should be consistent with the scope of protection of the knowledge community's discourse under the First Amendment. Only if liability and protection are coextensive can this...

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