1. © 2010 Jones and Bartlett Publishers, LLC A Practical Approach For Decision Makers SECOND EDITION EILEEN E. MORRISON

2. © 2010 Jones and Bartlett Publishers, LLC Class Thirteen: Moral Integrity and Codes of Ethics

3. © 2010 Jones and Bartlett Publishers, LLC Agenda Definitions of morality Definitions of morality Administrative evil Administrative evil Maintaining moral integrity Maintaining moral integrity Professional codes of ethics Professional codes of ethics Review of the ACHE code Review of the ACHE code Limitations of codes Limitations of codes Homework assignment Homework assignment Summary Summary

4. © 2010 Jones and Bartlett Publishers, LLC Where are we now? YOU Organization Community Theory

5. © 2010 Jones and Bartlett Publishers, LLC Morality Defined Morality involves the choices that help you live successfully with others. Morality involves the choices that help you live successfully with others. Can be divided into personal behavior and societal behavior. Can be divided into personal behavior and societal behavior. Also included group moral behavior. Also included group moral behavior. Morality is action; ethics is foundation for action. Morality is action; ethics is foundation for action.

6. © 2010 Jones and Bartlett Publishers, LLC What happens when morality is ignored? Moral derailment can happen. Moral derailment can happen. Dye (2000) gives some examples. Dye (2000) gives some examples. –Laziness, too much ego. Can you be ethics-based and still make money? Can you be ethics-based and still make money? Need to watch out for the shadow side of management. Need to watch out for the shadow side of management. What temptations will you face? What temptations will you face?

7. © 2010 Jones and Bartlett Publishers, LLC Administrative Evil Exists Actions that are efficient, effective, and cost appropriate can also be evil. Actions that are efficient, effective, and cost appropriate can also be evil. When you forget about humanity, then you can have extraordinarily evil behavior. When you forget about humanity, then you can have extraordinarily evil behavior. What does this look like? What does this look like?

8. © 2010 Jones and Bartlett Publishers, LLC Why does this happen? Moreno-Riaño (2001) says administrative evil happens when we reduce people to numbers and deny the human aspects of our workforce. Moreno-Riaño (2001) says administrative evil happens when we reduce people to numbers and deny the human aspects of our workforce. Discusses virtue or character ethics Discusses virtue or character ethics You should avoid being deaf to morality. You should avoid being deaf to morality. How does this fit with health care? How does this fit with health care?

9. © 2010 Jones and Bartlett Publishers, LLC Protecting your Moral Integrity How can you keep your moral integrity in a high pressure health care world? How can you keep your moral integrity in a high pressure health care world? Spirituality is important. Connections to something higher than you and a sense of belonging. Spirituality is important. Connections to something higher than you and a sense of belonging. Spirituality also includes meaning and purpose (Frankl). Spirituality also includes meaning and purpose (Frankl). Should we be attending to the spiritual connection to work? Should we be attending to the spiritual connection to work?

10. © 2010 Jones and Bartlett Publishers, LLC Maintaining your Moral Integrity Griffith says you can be moral and successful; do you agree? Griffith says you can be moral and successful; do you agree? You should become a moral beacon; foster integrity in your department. You should become a moral beacon; foster integrity in your department. Practice participative management and allow contrary opinions and ideas. Practice participative management and allow contrary opinions and ideas. You have a duty to self care and personal quality improvement. You have a duty to self care and personal quality improvement. Be vigilant. Be vigilant.

11. © 2010 Jones and Bartlett Publishers, LLC Professional Codes Thomas Percival wrote the first code of professional ethics in 1794 and invented the term, professional ethics. Thomas Percival wrote the first code of professional ethics in 1794 and invented the term, professional ethics. His code was for physicians. His code was for physicians. He tried to systematize moral judgments. He tried to systematize moral judgments. His code goes beyond just taking an oath. His code goes beyond just taking an oath.

12. © 2010 Jones and Bartlett Publishers, LLC Why are we concerned about professionals? We have power and are role models. We have power and are role models. We need to know what the profession expects. We need to know what the profession expects. Our codes are based on ethical reasoning and society’s expectations. Our codes are based on ethical reasoning and society’s expectations. We must remember that codes are guidelines not laws. We must remember that codes are guidelines not laws.

13. © 2010 Jones and Bartlett Publishers, LLC Why Bother? Why Bother? Ethical decision are not easy; codes provide guidance. Ethical decision are not easy; codes provide guidance. Acts like an ethics vitamin: helps to set boundaries. Acts like an ethics vitamin: helps to set boundaries. Codes are not just words; they should regulate your actions. Codes are not just words; they should regulate your actions. Helps you avoid the shadow side of administration. Helps you avoid the shadow side of administration.

14. © 2010 Jones and Bartlett Publishers, LLC ACHE Code The code is part of ethics materials. The code is part of ethics materials. What is your primary duty? What is your primary duty? Gives your responsibilities in 8 areas. Gives your responsibilities in 8 areas. Groups will interpret the meaning. Section II Aquinas Section III Kant Section IV Mill Section V Rawls Groups will interpret the meaning. Section II Aquinas Section III Kant Section IV Mill Section V Rawls Conclusions???? Conclusions????

15. © 2010 Jones and Bartlett Publishers, LLC ACHE also has Other Tools Examples of Policy Statements Examples of Policy Statements Policy: What are you to do? Policy: What are you to do? Also includes self assessments. Also includes self assessments.

16. © 2010 Jones and Bartlett Publishers, LLC Learning from other Codes Many HCAs are “bi-codal” Many HCAs are “bi-codal” What problems could this cause? What problems could this cause? What should a HCM do about bicodalism? What should a HCM do about bicodalism? Examples and lessons from other codes are in the book. Examples and lessons from other codes are in the book.

17. © 2010 Jones and Bartlett Publishers, LLC Examples of Criticisms of Codes Many professionals do not even know that they have a code of ethics. Many professionals do not even know that they have a code of ethics. Codes are not needed for moral people. Codes are not needed for moral people. Codes are about the profession not ethics. Codes are about the profession not ethics. Codes are only guides; they cannot be enforced. Codes are only guides; they cannot be enforced. Codes need to relate to the real world. Codes need to relate to the real world.

18. © 2010 Jones and Bartlett Publishers, LLC Homework Find a least one example of ethics hypocrisy. Find a least one example of ethics hypocrisy. Your community will be explaining this next class. Your community will be explaining this next class.