Ethical Issues For Managers
From Chapter 2 and Figure 4 (Schema for solving ethical problems), describe some of the administrative/organizational challenges as it relates to ethics that managers must consider when looking to solve ethical problems.
Must be at least 250 words
Supported by at least two references
Darr, K. (2011). Ethics in health services management, fifth edition. Retrieved from https://ebookcentral.proquest.com
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CHAPTER 2
RESOLVING ETHICAL ISSUES anagers are problem solvers. It is the reason they are hired—organizations without problems need no managers. Some problems burst on the scene. Something is clearly
amiss when a wildcat strike occurs among the nursing staff or when a newspaper editorial attacks the organization. Other problems are hard to uncover and often provide no clear evidence or warning. They must be identified and treated early; undetected, they will grow and may threaten the organization’s survival. The aphorism “a stitch in time saves nine” is never truer. Solving them is similar to detection and early treatment of disease.
Successful managers possess highly developed conceptual and problem identification skills. Preventing (if possible) or identifying and solving ethical problems with the least disruption to the organization are as critical as solving management problems affecting personnel or finances. Ethical problems have implications for traditional management areas, and traditional management problems have ethical dimensions. It is important to note in using this comparison that the techniques and skills employed in solving ethical problems have many similarities to those needed to solve management problems. Problem solving is a generic process applicable to both.
IDENTIFYING ETHICAL PROBLEMS
Often, managers believe that they are inadequately prepared to recognize ethical problems and even less able to solve them. This view understates the typical manager’s credentials and abilities. Identifying ethical issues that could become problems is primarily a matter of mind- set, attitude, sensitivity, and application of common sense when reviewing or analyzing a situation. Identifying an ethical problem and its dimensions is often less difficult than developing and implementing morally acceptable alternative solutions. Developing and implementing solutions will likely require assistance from elsewhere in the organization or even from outside it.
Managers who see their function only as solving problems of staffing, directing, budgeting, controlling, organizing, coordinating, integrating, and planning are more in need of increased awareness of ethical issues than postgraduate education in philosophy. Methodologies similar to those used to solve traditional management problems can be used to solve ethical problems, whether they are administrative or biomedical. (This generic process is examined later in the chapter.) However, traditional management issues often overshadow and may even overwhelm the ethical dimensions that invariably accompany them. In addition, the ethical dimensions of managerial problems can be subtle, which complicates initially identifying and then solving them.
Managers use authority delegated by the governing body to represent the organization. As discussed in Chapter 3, the organization’s philosophy provides a general context for the
Darr, K. (2011). Ethics in health services management, fifth edition. Retrieved from http://ebookcentral.proquest.com Created from apus on 2020-05-04 08:10:03.
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manager’s activities and decision making. The presence of an organizational philosophy, however, does not eliminate the manager’s need for a personal ethic. A personal ethic provides a framework—a grounding—for decisions and permits greater refinement of principles, rules, and particular judgments (as well as actions or nonactions) than is likely using only the organization’s statement of philosophy. It bears repeating that each human being is a moral agent whose actions, nonactions, and misactions have moral consequences. Morally unacceptable conduct cannot be excused because someone was “following orders” or policy, regardless of their source. Orders from lawfully constituted authorities, such as courts, pose a special problem. Moral agents who consider such orders unjust or immoral may engage in civil disobedience, but in doing so, they must be prepared to bear societally imposed sanctions. The ethical (moral) implications of acts must be considered independently.
Occasionally, there is conflict between the organization’s ethic, as expressed in its philosophy, and the manager’s personal ethic. The organization is a bureaucracy and the manager must carefully consider the implications of acquiescing to its values. This follows from the concept of moral agency. Often, it seems easier to “go along to get along” than to risk one’s position by speaking out. Professional dissent or whistle-blowing are rare, despite evidence that sharp or dishonest practices, criminal behavior, or activities that pose a danger to the public are not uncommon in organizations, even those in the health services field. Managers must recognize both the distinction between and the integration of an organizational and a personal ethic. They must not perform their daily tasks with little thought to the ethical context or implications of what they do, fail to do, or do badly.
In terms of the problem-solving methodology described below, the organization’s philosophy and the individual’s personal ethic are vital. They provide the framework and context in which the manager functions, and they enhance sensitization to and identification and solution of ethical problems so that managers can approach these problems as they would those of traditional management.
Another technique that may be useful in identifying ethical problems is the ethics audit. Conducted much like a financial audit, an ethics audit uses a set of criteria to compare actual with desired performance. Small increases in some measures should alert managers to actual or potential ethical problems: patient complaints, incident reports, and legal actions; employee grievances, resignations, terminations, and wrongful discharge complaints; medical staff complaints and resignations; problems with suppliers and other vendors; and adverse publicity. The ethics audit has three steps. First, analyze key documents (e.g., mission, vision, and values statements) and their operationalization in policies and procedures, with special attention paid to issues such as uncompensated care, confidentiality, consent, conflicts of interest, and sexual harassment. Second, survey representative board members, managers, physicians, employees, volunteers, and community residents and organizations to determine whether actual performance matches that desired. Third, address deficiencies through education or other appropriate strategies.1 Compliance or noncompliance with laws and regulations raises other ethical (and legal) issues.
Administrative Ethical Issues
Darr, K. (2011). Ethics in health services management, fifth edition. Retrieved from http://ebookcentral.proquest.com Created from apus on 2020-05-04 08:10:03.
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Leadership is essential in management. It includes setting goals, establishing direction, and guiding the organization. These tasks are more ethics-sensitive than are many routine managerial activities. Day-to-day activities (i.e., transactional leadership) seem less tied to values, but even these are based on earlier decisions rooted in ethical principles, whether or not those principles are identified and expressly stated. However management functions are interpreted, human beings cannot escape their role as moral agents. Managers set a tone and establish a context for the organization and staff. They can neither avoid scrutiny of their personal ethic nor ignore its congruence with the organization’s philosophy.
Managers hold positions of trust, which may not be used for personal advantage or personal aggrandizement. These are essential elements of a personal ethic if one seeks to be an effective leader. Managers must not act in any ways that raise the slightest hint of wrongdoing. Actions (and nonactions and misactions) should be judged by applying the ethical principles and virtues discussed in Chapter 1. Another effective way to clarify the pragmatic effect of an action is to step back, as though one were an outsider, and view what is being done or contemplated. One should ask, “How would the public and my colleagues see this decision?” This “as seen through the eyes of others,” or “in the light of public scrutiny,” standard for judging managerial decisions is helpful. A cynic’s standard is not useful—meeting it is impossible because cynics see problems when it is unreasonable to do so. Skepticism is a useful criterion for managers to apply as they seek to understand how their actions might be interpreted. A standard of discovery is unacceptable because the concept of “if you don’t get caught, it’s okay” negates the need for ethics and substitutes deviousness and deceit.
In a way quite different from a personal ethic or an organization’s philosophy, the law is a baseline of what is considered ethical. The Introduction noted that laws provide useful comparisons; however, they guide us only partially because the law is a minimum standard of conduct, and no manager is effective by meeting minimum requirements. The manager qua leader must set an example that substantially surpasses what is expected of others. Professional codes also guide conduct and provide frames of reference. These codes have a more demanding level of performance than the law; however, they should be seen only as partially incorporating…
