It continues to amaze the layperson that such otherwise bright and professional people can continue to delude themselves; yet they do. What is going on here is just an intensification of defensive processes that we all use at one time or another to maintain our self-esteem: We deny that we have done anything wrong, and we project blame for unacceptable or illegal actions onto others, an all-too-familiar process that we must deal with again and again in ordinary and organizational life -- self-righteousness, covering your butt, blaming the other guy, and denying the fearful possibility that maybe we really are rotten, no good persons."1
Ferrell and Gardiner recognize that, "Many intelligent and thoughtful persons have never had any training in ethics, and sometimes just don't recognize certain types of ethical conflicts. Sensitivity to potential ethical conflicts must sometimes be enhanced by appropriate training.
"Much training in the field of ethics, unfortunately, takes the form of heavy-handed and preachy repetition of themes of 'Don't do Bad Things, Be Good,' which have a quick and predictable outcome -- they turn people off. In each generation, it seems, educators must rediscover the principle that the most effective education teaches people to think for themselves. In the field of education, this is doubly true. Effective training programs tend to focus heavily on the case-by-case analysis, involve participants extensively in discussion and interaction, and stress the need for each individual to learn an ethical choice process that is uniquely his or her own."2
The questions below are a tool I hope some of you will use to help you look at professional problems and situations. These 12 questions for examining the ethics of a business decision were developed by Harvard Business School Professor Laura Nash, who wrote "Ethics without the Sermon" in the Harvard Business Review.
- Have you defined the problem accurately?
- How would you define the problem if you stood on the other side of the fence?
- How did this situation occur in the first place?
- To whom and to what do you give your loyalty as a person and as a member of the organization?
- What is your intention in making this decision?
- How does this intention compare with the probable results?
- Whom could your decision injure?
- Can you discuss the problem with the affected parties before you make your decision?
- Are you confident that your position will be as valid over a long period of time as it seems now?
- Could you disclose without qualm your decision or action to your boss, your CEO, the board of directors, your family, society as a whole?
- What is the symbolic potential of your action if understood? If misunderstood?
- Under what conditions would you allow exceptions to your stand?3
We need tools for ethical decision making. Let's use tools such as this one to clearly bring ethics into our thinking and discussions. Try out these questions on that knotty situation that you have in the back of your mind.
Try talking to colleagues about the ethics of business decisions. Make an effort to discuss patient management and business decisions in terms of ethics. Be a person who regularly, systematically examines the ethics of decisions. Thousands of us doing this consistently will improve our profession.
Ultimately, there is still no powerful authority, no absolute, agreed protocols for the care we render, although the Mercy Guidelines are close. Chiropractic ethics will continue to have many gray areas. We need more clarity about the ethical issues involved in what we do. Each of us needs to answer questions for each patient before us, "Am I treating this patient's needs? Or, instead, am I treating my own need or my own greed?"
Searching your heart to overcome the natural tendency towards self-righteousness and denial is more difficult than using the 12 questions above and more difficult than speaking about the ethical aspects of business decisions. Yet doing what's righteous, rather than self-righteous, can require you to search your heart.
References
- Ferrell OC, Gardiner G: In Pursuit of Ethics: Tough Choices in the World of Work. pp 62-64. Smith Collins Co., P.O. Box 20258, Springfield, Illinois 62708, Phone (800) 345-0096.
- Ibid, pp 132-133.
- Ibid, p 123.
Linda S. Elyad, DC
San Rafael, California