Monthly Archives: January 2007

Ethics in Business – From Compliance to Commitment

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Rana Group asked:

By the time this article goes to print all of us will surely have had our fill of news reports about Conrad Black’s infamous lawsuit.  We’ll likely be numb to the never ending allegations of fraudulent practices at Nortel. But, how many of us as human resource professionals will be asking, ‘What does this have to do with me?’

It seems that, by and large, human resource professionals have been quite happy to have the accountability for their company’s business ethics and code of business conduct rest with their legal or audit departments.   In so doing, human resource professionals miss an opportunity to help their companies shift from merely being compliant with the law to demonstrating their company’s firm and unwavering commitment to build an ethical business culture.

The ‘iceberg model’ helps us to better appreciate the influences that may undermine a company’s policies and practices with respect to business ethics.  Think of the ‘the Law’ and your company’s Code of Business Conduct Policy as the tip of the iceberg, visible above the surface.  Now, think about the influences that exist below the surface lurking within many companies.  Things like:

·        Pressures to conform (“Hey, we always take off early Friday afternoons, you need to join us or else someone’s going to take notice”)

·        Desire to please (“I picked up the tab for a lunch I had with my boss. He told me it was the only way he could expense it without needing to get further approval. I did it because I wanted to stay on his good side!”)

·        Accepted practices (“Don’t worry, we give box seat tickets to all our clients and they sure don’t have any problem with accepting them!”)

·        Performance drivers (“Hey, maybe we should just alter our numbers a bit.  If we do, we’re sure to be in the top category for a bonus this year!”)

When asked, most of us do not hesitate to say that we are ‘ethical’.  In fact some people are offended when asked to sign a document confirming they have read and understood their company’s Code of Business Conduct Policy.   However, what we fail to recognize and appreciate is our ability to rationalize our own behavior.  Sometimes we justify our actions so convincingly that we no longer even perceive that what we are doing is inherently wrong or unethical.  For example:

“I’ll just pad my mileage claim this month, it’s not like I haven’t worked hard.  The company owes it to me.”

“I know I shouldn’t provide my son with supplies from the office, but university is so expensive and, I know this company can afford the photocopying I do and the pens and paper I take.”

“If this company can afford a company jet, hey, they can afford for me to take a few sick days to ski!”

It is a slippery slope once employees believe they can justify actions and decisions that are fundamentally unethical.  Reading a code of conduct policy and signing a piece of paper every year does little to help employees grasp and understand the essence of ethical conduct.  Nor does it help employees apply good problem solving skills when they are faced with ethical dilemmas in the workplace. It may surprise some to know that virtually all the companies who have become household names (including Enron) as a result of their unethical business practices had well articulated policies and codes of conduct dutifully signed off yearly by their employees.

Few companies are making the effort necessary to address these underlying influences and regrettably, only those that do will truly build ethical cultures.   By taking the following 7 steps, human resource professionals can play a critical role in helping their companies move beyond compliance, raising the bar  to demonstrate their deep commitment to developing an ethical business culture.

1)      Adopt a multi-disciplinary approach to building an ethical culture

2)      Communicate your Code of Business Conduct in plain language

3)      Ensure relevant policies, processes and practices align with your Code.

4)      Develop ethical leadership

5)      Gain employee buy-in

6)      Facilitate reporting

7)      Model the way

 Adopt a Multi-Disciplinary Approach

Human resources must have a ‘seat at the table’ when matters of business ethics and code of conduct are discussed.  That said, it would be wrong for human resources to act independently.  Companies that are truly committed to developing ethical cultures adopt a multi-disciplinary approach that includes representation from their legal, financial, communications and human resource disciplines.  Working together they develop a strategy that enables the development of an ethical culture that is truly sustainable.

Use Plain Language in Your Code

Most human resource departments do provide employees with a personal copy of their company’s Code of Business Conduct Policy at the time of hire.  Many companies host their Code of Business Conduct and related policies on their intranet.  However, few companies have taken the time to provide a document that is actually readable!  By working with their partners in Communications, Human Resources can provide employees a document that is both easily referenced and easily read.

 Align Policy and Practices

More than one company has been surprised to learn that upon review, some of their policies and accepted practices are not consistent with their company’s Code of Business Conduct Policy.  Human resources can ‘lead the way’ by ensuring its policies and practices are ‘squeaky clean’; not only in the way they are written, but also, in the way they are executed.  However, it is not only human resource policies that require review, virtually all corporate policies need to be reviewed in light of the company’s Code of Business Conduct Policy to achieve proper alignment.

Develop Ethical Leadership

Developing ethical leadership ought to be a primary goal of every leadership development program.  Surely it is the role of human resources to ensure the topic of business ethics is adequately addressed in all leadership development programs.  Not only do leaders need to know and understand their company’s Code of Business Conduct Policy but, they must also understand the role they play in facilitating an ethical culture.  This is just as true for leaders at the frontline as it is for leaders at the executive table.  Leaders often justify their own behaviors based upon what they see modeled by those to whom they report.  Ethical leadership depends upon each leader understanding they are responsible and accountable for their personal actions and behaviors regardless of the actions of those at more senior levels of the company. 

Demonstrating ethical behavior as a leader is inextricably linked to building trusting relationships, the cornerstone of many leadership development programs.  However, while many of these programs address the matter of trust and trusting relationships, few make the link to ethical behavior and the expectations of leaders.  Whether through instructor-led training or on-line training, every leader needs to have exposure to the topic of business ethics.  Leaders must be fully cognizant of behaviors that develop a strong ethical culture and those that erode that culture.  They need also to understand their accountability when employees raise ethical issues and/or report unethical behavior. 

Gaining Employee Buy-in

Ethical cultures are built when employees, like leaders, have exposure to training that helps them differentiate between ethical and unethical behavior.  Depending upon the size of your company this can be accomplished either through instructor-led or on-line learning modules.  Regardless of the methodology, employees need to be exposed to different scenarios and situations that they may face within their own work.  Employees need an opportunity to learn in a non-threatening environment what is appropriate and what is inappropriate.  Your company’s Code of Business Conduct Policy is an important topic that must be addressed not only in all employee development programs but in your company’s orientation program for new employees.

However, learning in and of itself is insufficient.  Building an ethical culture requires continuous reinforcement through a well thought out and on-going communication strategy and plan.  Ethics needs to be woven into company newsletters, be reinforced through visual cues such as posters, and integrated into team discussions if a company is going to make significant head-way towards building a strong ethical culture.

Facilitate Reporting

Companies need to provide their employees with a means of reporting behaviors, decisions or actions they perceive are unethical and contrary to their company’s Code of Business Conduct Policy.  This is best facilitated by providing access through a third party provider although many smaller companies encourage such reporting to their legal department or external legal counsel.   That said, it is only through both educational and communication programs that employees understand their obligation to report unethical behavior and to realize that their company will fully support their actions provided, of course, that the reporting of unethical behavior is not maliciously motivated.

 Model the Way

 Finally, human resource professionals must model the way.  For new employees, human resource employees are like a beacon signaling the strength of a company’s ethical culture.  And, whether we realize it or not, the manner in which we conduct employment searches and implement recruitment practices sets the tone.  Employees tend to assess the strength of a company’s ethical culture based upon their own personal experience and the experience of those with whom they have a close work relationship.  They are sensitive to preferential treatment whether in regards to recruitment, compensation, performance management, or succession management and promotions.  Human resource professionals must demonstrate through their actions an unerring commitment to ethical business conduct.

 Since the Enron fiasco it’s hard to pick up a daily paper without seeing some reference to or allegation of unethical business practices.  And, based upon these articles it would be easy for us to assume that unethical behavior is limited to those at the very top of organizations.  This is simply not the case.  While building an ethical culture depends upon the full commitment of senior executives to set the standard of acceptable behavior,   each and every employee directly influences the strength of your company’s ethical culture through their day-to-day actions. Cleary, code of business conduct policies are insufficient in and of themselves to shape ethical behavior.  Human resource professionals must help their companies move beyond compliance with the law and, they can do so by ensuring each and every employee develops the knowledge and skills necessary to build strong ethical cultures. 

Legal And Ethical Issues Of Organ Transplants

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Chris Chew asked:

One of the greatest achievements in medical science is organ transplant surgery. People who have failing organs and are doomed to die can now be given a new lease on life by the generosity of organ donors who are giving part of their own bodies to save or enhance the lives of others. However, there are many ethical issues and controversies pertaining to organ transplants.

Discussions on the ethics on organ transplants invariably will attract questions like for instance:-

Can human organs be traded commercially, if not why? Should a person who has already received one transplant be allowed another one? Should alcoholics be given liver transplants, where after all, it was their alcoholism that damages their livers in the first place? What are the sources of organs used in organ transplants operations?

Perhaps the most controversial topics of these ethical debates are about the procurement and distribution of human organs for transplant and are centered on the questions of how do we get the organs and how do we decide who will receive organ transplants?

Since there are always fewer organ donors than there are potential recipients, this fact make the debate on who should get the organ available very emotional and heated which is not surprising because lives are at stake.

To compound the problem, organ transplants are very expensive surgical procedures and only the rich can afford them. Poorer folks may never get the opportunity of a transplant even if they need it more urgently than their richer counterparts. Should the choice of who get the organs be dependant upon who can afford it?

Then there is the issue of not everyone agreeing when death of the donor actually occurs. Is it when the heart and lungs stop functioning or the donor is certified brain dead?

What about consent of the donor? At the present moment, a donor has to expressly agree for organ donor ship in order for organs to be removed except in Singapore which have the controversial Human Organ Transplant Act (HOTA). The Act assumed that all Singapore citizens have consented to be organ donors unless opted out. However, Muslims are exempted from the Act for religious reasons.

Which is the better way to get consent from the donors? By enacting legislations or relying on willing donors?

Since most people can live with only one kidney or one eye, which are organs which can be donated while the donor is still alive. Should the donor be allowed to sell his kidney? The argument against allowing commercial trade on human organs is that it may encourage poor people to sell their organs and even may encourage unethical syndicate organ trading rackets.

There are people suffering and are on the death row waiting for organ transplants to save their lives and decisions about the ethics of organ transplants will have a tremendous impact on them. What is your position on these ethical issues of human organ transplants?

Mental Health Ethics: Euthanasia

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Pedro Gondim asked:

Euthanasia (Greek: ????????? – ?? “good”, ??????? death”), according to the Penguin Dictionary of Psychology, is described as the “easy and painless death or the means for producing one. Advocated by many for those suffering from intractable pain that accompanies the terminal stages of many incurable diseases. A distinction worth noting (in respect to matters legal and ethical) is that drawn between passive euthanasia, when one simply ceases to supply requisite extraordinary support measures needed to keep an individual alive, and active euthanasia, when specific means are taken to terminate life.” (Page 253)

Active Euthanasia, Passive Euthanasia and Assisted Suicide

The distinction between these terms is one of the main discussion points regarding euthanasia and its legal-social effects. The so-called active euthanasia, as previously described, consists in a direct or indirect action with the purpose of ending one’s life. Such actions would include, for example, the injection of a lethal substance into the patient’s bloodstream. The passive euthanasia consists in ceasing life support supplies (or treatment), such as a respiratory tube or a specific medication.

Although this does not constitute in a direct action towards ending one’s life, it does have the same purpose and result. In legal terms, both definitions fall under the same category – and there are people who argue that passive euthanasia is a mis-term of what would be simply another active form of the event. In the other hand, assisted suicide is the term which defines the supply of means to end one’s life. It is almost the same as euthanasia; the difference is that in this case, the patient is responsible for performing the final action which results in his/her own death. This definition comprises the term physician-assisted suicide, which occurs when a doctor assists a patient, whether by giving information or access to means, to commit suicide.

This has been the center of much discussion among several societies, as it represents a paradox to common medical ethics* – and it also raises a discussion of priorities in health care.

*Most doctors are ethically obliged to the Hippocratic Oath, a document written by the famous Greek physician Hippocrates, which states that a doctor shall not provide any means to help producing death.

The ‘Slippery Slope’ Argument

A common person would probably argue that, upon request, an individual should be allowed to choose between life and death. After all, it is a matter of freedom of choice, which is one of the basic principles of a democratic society. However, both euthanasia and assisted suicide invoke a deeper concern in health specialists – a problem commonly called the slippery slope.

According to them, the legalisation of both practices would cause the society to gradually switch their views towards life and death issues involving severely ill, disabled (both mentally and physically) and other patients unable to express their will – allowing euthanasia to be such a common practice that, at some point, patients would feel pressured to end their lives in order to spare resources to maintain them alive, or end their family suffering. In an overall perspective, life would be less valued, and people would become increasingly insensitive to patients in severe conditions.

Palliative Care and the Development of Health Care

Some advocates of the previous argument also affirm that, in a certain period of time, when healthcare has become widely available and non-costly – it would be possible to legalise both euthanasia and assisted suicide. Ideally, those conditions would allow both medical staff and the public to place life care as an ultimate priority. This can be considered as utopian, however, the progressive advances in technology could play a main role in creating this environment.

Current Situation

Until this article was written (2005), only few places in the world legally allow euthanasia and assisted suicide. The only country to approve both practices is the Netherlands. Meanwhile, Switzerland and the US state of Oregon allowed assisted suicide, and in Belgium, only voluntary euthanasia (authorised by the patient) is fully legal. Other areas, including the UK, have been analysing the possibility of legalising one or both of these activities. In 1996, The Rights of the Terminally Ill Act (ROTI) was passed by the Parliament of the Northern Territory by one vote. In 1997, the Australian Parliament overturned the ROTI Bill, and voluntary euthanasia became illegal again.

The discussion around euthanasia remains a polemic and unsolved issue. Several pro-euthanasia institutions have been established throughout the world, and every year, a growing number of patients travel to Switzerland in order to peacefully end their lives. However, researched data has not concluded whether the slippery slope effect will become prominent or not – and whether other issues regarding the legalisation of euthanasia could take place.

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Ethics in the Field of Nursing

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Shawn Thomas asked:

Nursing is a profession that demands trust. A patient places their health and well being not only in the hands of their physicians, but in the hands of their nurses as well. So, to ensure that new nurses understand, and experienced nurses remember, this aspect of their profession, a nurse’s code of ethic was developed. Ethics in the field of nursing are meant to hold nurses accountable to the highest standards for patients care. It is important to note that there are many versions of this code. However, since most the notable difference is the terminology and level of detail in which each topic is described, we will touch on the most common concepts or provisions.

The first and most important provision of ethics in the field of nursing is to practice with the compassion and understanding that all individuals should treated with dignity and respect regardless of their health problems, social status, race, religion, disability, financial status, or creed. This particular ethical provision is broken down to further outline the importance of a nurse’s relationship with patience, the respect for human dignity, the relationships with colleagues and peers, and the right of self-determination, or a patient’s right to decide their fate provided they are given accurate information regarding their condition and options.

The second provision in the code of ethics for nurses is that a nurse’s primary commitment is to the patient. This section discusses how nurses should wade through conflicts where a nurse’s patient and others, typically family members, other loved ones, or employers, have differing opinions on care and treatment needed. In these situations a nurse must maintain the integrity of the nursing profession, by safeguarding the patient’s best interest. This provision also specifies the need for collaboration between nurses, other medical professionals, and any other person relevant to a patient’s care. Finally there is section that outlines the need for professional boundaries. The code of ethics describes the need for nurses to maintain professionalism in relationships with patients and colleagues in order to ensure their patients receive the best care possible.

Next, there is the need for a nurse to promote not only a patient’s health and wellbeing, but also the rights of a patient. This provision covers the need for privacy and confidentiality. This section specifies that only the information vital to a patient’s health should be disclosed and only to those who are directly involved in that patient’s care. However there are exceptions to this provision. Information should also be disclosed if it may protect other individuals or become a public health concern. There are also exceptions to the rule for things such as peer reviews, third party payments, lawsuits, and rehabilitations; but patient information must be disclosed in a way that upholds any and all privacy policies, protocols, laws, and/or regulations. Taking appropriate action when any member of a health team is acting inappropriately or practicing under any undo influence is also covered under this provision.

The fourth provision discusses the need for nurses to take responsibility and to be held accountable for their actions. The actions of a nurse will affect a patient’s standard of care. Therefore, nurses must ensure that they show sound judgment in treating patients and delegating tasks to other nurses. In delegating, nurses must ensure that they delegate to a healthcare professional who is capable and qualified to complete the task.

Since nursing can be a thankless profession, the next provision mandates that nurses treat themselves with the care in which they treat their patients. This provision calls for the nurse to continue to grow and learn their craft; take time for him or herself; and, preserve their integrity and moral self-respect.

There are also provisions that outline a nurse’s responsibility to the public and the need for nurses to positively influence their working environment. Nurses have a responsibility to use their knowledge for the betterment of those around them. They should not get caught up in the negativity of others, even if it is coming from coworkers or superiors in their workplace.

The final provisions call for nurses to strive to take the profession forward through research, identifying health needs and concerns, and by staying abreast of and implementing best practices for patient care, healthcare, and new technology.

Ethics in the field of nursing is as important as the profession itself. So to ensure uniformity the American Nurses Association created a Nursing Code of Ethics. However, it is important to note that although this is the most popular code, there are others, specifically for various other countries. This standard for nurses has been updated over the years and will continue to change with the healthcare industry. Yet, the heart of the ethical code for nurses is and will always be the health and welfare of their patients.

So Who Do You Believe? Pharmaceutical Ethics

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Dr Karen asked:

There are various reasons why many people are skeptical about taking prescribed medications. Some believe that there are just too many chemicals in them and would prefer a more natural approach. Others feel that prescribed drugs are being used too freely. What many people have not considered though is the fact that they may be being deceived regarding the quality of the prescribed medications.

We all assume that medical research is documented and properly researched at least when it comes to inventing new drugs and treatments. After all, we have strict government regulations in place to ensure our safety. It appears that we may not be as protected as we may assume.

It has been found that a particular pharmaceutical company has been using employees to ghostwrite research material and then having the appropriate medical personnel attach their names to it thus making it appear as valid research information. Yikes! What makes it even more disturbing is that it doesn’t seem to be an isolated incident. Apparently, there are numerous claims that ghostwriting medical research is a common practice within the pharmaceutical industry.

Not only can this practice be viewed as alarming and dangerous but using another’s research is also unethical. Coming to basic facts, it is downright scary because it involves public health and safety. So far, little news press has been given to the potentially grave consequences of these practices, but the US Food and Drug Administration are now in the process of determining whether to allow the circulation of peer-reviewed journal articles to be used as guides. While in the past physicians have used these articles to determine drugs of choice for a particular patient, the FDA will look into the efficacy and safety of this practice to decide its future worth.

What needs to be taken into consideration is how much attention does the professional signing this research really give to its content? He or she could be recommending a medication that will reach the people at large and could prove not only mildly detrimental but also downright dangerous. After all, professionals are needed in medical and pharmaceutical research to prevent such an eventuality. If their research means so little, then why not dispense with it and let the ghostwriters do the research and clear the drug for open market? All of the current indicators are pointing in this direction right now. No claims can or should be made that this is happening in every pharmaceutical company as they each have individual moral and ethical standards. We the public can only hope that the companies making such prescribed drugs fall into the “good moral” category.

One good aspect is that at least this deception is being brought to light. Other pharmaceutical companies that are walking a fine line on this issue may think twice about the consequences of their actions. For all of our sakes let’s hope that they do.

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