Code of Ethics

Ethical Issues Faced by Managers

Ethical issues are present even in routine daily decisions of a manager. Managing involves ethics at every level from small personal decisions to large public policies. It may be appropriate to regard most managerial decisions as being permeated by ethics, rather than to regard ethical considerations as tangential issues. Because managers have power that affects people's lives, there is a potential for them to act in a good or evil manner. Managers who make incorrect decisions to promote their own interests are unethical. In addition, any situation that is less favorable than it could have been is ethically compromised. Managers should attempt to distribute resources in a fair manner; however, a fair distribution is not always an equal distribution. Managers design and enforce organizational rules. Their ethical responsibility is to produce a system of shared values and expectations that is realistic and fair. Managerial decisions may be ethical because they may test the manager's personal values. These types of conflicts involve discrepancies between personal and organizational values. Managers act as the link between organizational success and the lives of the individuals whom they manage.

Ethical behavior may be encouraged by designing organizations with optimal distribution of power and minimizing pressures that might otherwise encourage unethical behavior. Managers should seek to create a corporate culture of openness and cooperation. Efforts should be made to understand the factors in organizations that enhance or distort human values and behavior.

Four examples of ethical issues for managers follow:

• External effects of
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    Unsafe consumer products or services
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    Arrogance in dealing with “foreign” people—people who are different from “ourselves”
• Internal conflicts
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    Negligence in guaranteeing the health and safety of employees
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    Foot-dragging among members with regard to affirmative action
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    Foot-dragging among members regarding equitable promotions
• Conflicts of
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    Decisions to shut down a profitable unit, leaving local individuals and managers to handle the fallout
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    Rushed schedules that jeopardize health and safety regulations
• Stakeholder value conflicts on (for example)
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    Issues related to placement of an MRI machine
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    Possible safety hazards, costs, resource depletion
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    Return on investment and long-term health of the company

Health Care Organizational Issues

Obvious organizational issues that present opportunities for physician leaders to lead with ethics include the following:

• Employee rights: due process, privacy
• Sexual harassment
• Whistle-blowing
• Misuse of power
• Discouraging intrinsic motivation
• Selection and placement
• Corporate culture
• Corporate social responsibility
• Agreed-on incentive system versus actual system
• Terminations
• Organizational structure, design, and politics
• Performance appraisals
• Drug testing, physical exams
• Diversity/discrimination
• Planning, policy, control
• Government relations
• Safety/health issues
• Technical development
• Foreign payments
• Environment protection
• Product safety, reliability
• Quality management
• Purchasing (gifts, bribes)
• Automation, robotics
• Confidentiality
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• Inappropriate requests
• Intellectual property
• Truth in claims
• Organizational versus individual needs
• Customer and user participation
• Conflicts of interest
• Personal biases
• Individual and population differences
• Appropriate interventions
• Intervention consequences
• Fair pricing