Previous Sphere One pertains to direct patient care decisions that fall within your area of professional expertise. Understandably, this remains the major focus of your moral agency in the clinic and beyond.

Sphere Two describes an area of moral authority that exists when you encounter a situation that is not direct patient care but you have important professional knowledge, insight, or skills that can help to effectively address the issue. In Sphere Two, the more your role as a professional prepares you better than any other group in society to address it, the more you will be looked to as an authority. For example, the more education a dietician has on the effects of snack food on childhood obesity, the more other parents on the school PTA board will look to her for advice regarding the proposed debate to institute a public mandate regulating the vending machine contents. And because of the moral role of the professional in society, the professional has the added power of being viewed as a moral agent who upholds deep societal values.

Sphere Three shifts the emphasis from your professional knowledge and skills base to the fact that professionals are held in high regard in society. Health professionals, lawyers, and religious leaders generally enjoy a high status, although they become the brunt of deep criticism when they do not stand up to society’s realistic (or even unrealistic) expectations. Often the gravity or urgency of a situation is expressed more forcefully when professionals get behind the cause and provide leadership in endorsing it. This is seen in everything from television ads to appeals for financial contributions for societal issues. Your voice can influence the outcome by virtue of being a professional, although you may have little significant or unique professional knowledge regarding the issue under consideration. In this

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