The Hard Road of Ethics

The issue of workforce reduction is one that rings close to home for me. After reading Chapter 5 in The Tracks We Leave which addresses workforce reduction, I had several distinctions that became evident as a result of my past experiences.

In my days of working as a pharmaceutical rep I learned so much about company culture, managing people (what not to do more than what to do) and how long term businesses should be run. My time in the Master’s program at UCF has been critical in understanding my past experiences from a business perspective and what I can learn from it all.

The chapter on workforce reduction particularly struck a chord with me. When I worked at the pharma company I got a crash course in what it was like to work for a morally depleted organization. When I was hired to work there in early 2008, the company had already had one layoff the year before and by the time the fall of 2008 rolled around there was already talk of another reduction. And it was true. There was another reduction.

I survived that round despite my non-existent tenure but the remaining days at the corporation proved to be extremely demoralizing. The company was the perfect example of an organization that overused corporate jargon like “we value transparency” and “integrity is king” but the actions of the leadership team were so contradictory. Some managers used fear and manipulation to control team members and senior executives would outright lie about the state of the company when the entire workforce knew that we were in trouble.

By the time they were ready to have their next layoff in the summer of 2010, I volunteered to leave and took my severance pay because I couldn’t foresee spending another day working for such a compromised organization—compromised in integrity, that is. Once I left, I started a business with my husband and it has been the best decision that I’ve ever made.  

What I’ve come to realize throughout this course (in a new way) is that to be an organization of excellence it’s HARD. It’s hard to always do the right thing when no one is watching. It’s hard to be ethical with all employees. It’s hard to take on the humility that is required to be an outstanding leader. It’s hard to make ethical decisions that may not benefit the company but they are the right thing to do. Because of these challenges many organizations concede to the pressure of running a business.

One of the most significant things that I’ve realized throughout this course is the diligence and persistence that is required for an organization to uphold itself to the highest ethical standards. My goodness, reading through some of the case studies in The Tracks We Leave left me dumbfounded. Considering all of the stakeholders and the values of the different individuals in an ethical dilemma is taxing. It requires a lot of thought and conscientiousness. It can’t always be a swift decision—especially in health care where answers are not always black and white. I at least feel like I am more equipped to handle such dilemmas and as I grow in this area it will become easier and easier.

My belief is that leadership teams need to understand these challenges. Not just the challenge in recognizing the ethical dilemma from different perspectives but the challenge of actually doing the right thing. Sometimes corporate conferences and ethics campaigns can oversimplify this to the detriment of the leadership team. If it were as easy as some are led to believe, then overall we would see a more equitable and integrity-based workforce. It is the responsibility of the leadership to make the commitment to do the hard work of upholding ethical decision making even when it may not be popular to do so. 

My Real Thoughts on the Debate

I enjoy debating and this is the second course in the Master’s program where I’ve been able to debate as a part of the course content. It’s always challenging to debate when you don’t necessarily agree with the topic that you’ve been given. It’s interesting because toward the end of the debate I actually started to believe my arguments! (Maybe that means that I argued my points well). :-)

Out topic was that health care professionals should not be exempt from patient situations where they have conscientious objections. The more I learned about this topic the more I realized how challenging it is. On the one hand you have health care providers who also have a conscience and a belief system that may not necessarily “gel” with that of the organization. And on the other hand you have the organization that wants to make sure that there is order and process and more objectivity than subjectivity. That’s what keeps them protected legally and otherwise. Of course, in the midst of all of this is the patient’s wellbeing that must be considered. It can be a pretty challenging situation.

I had a few primary issues with both sides of the arguments. First, the argument of the pro side was that no individual should be required to act against their conscience. I don’t agree with that at all simply because of the varying perspectives of what is right and wrong from one person to another. In my argument I frequently cited a study of psychologists who had done some very unethical things in the name of patient welfare and their “deeper values” (i.e. their conscience). Sometimes I think that because doctors are doctors we automatically believe that they have sound judgment. This is not always the case and leaving a doctor too much wiggle room on what they believe to be morally right is a risky situation.

I also have issues with my own argument which says that there is too much subjectivity in allowing doctors to remove themselves from certain situations where they have a moral conflict. It’s true that there is a lot of subjectivity there, but I also believe that in many cases that is exactly what the health care system needs. To leave everything to objective measures, laws and regulations implies that we have a perfect system—that if we just follow the rules of the system that in the end it will all work out and everyone will be happy. This is not always true and even if the goal is not for everyone to be happy, but it’s to uphold the patient’s best interest that doesn’t always happen either. We’ve all heard stories of the drama that people go through with insurance companies or taking a prescription drug that causes harm to the patient.

In my opinion, there’s no real way to be on one side or the other when it comes to professional rights and conscientious objections. In reality, I tend to lean somewhere in the middle of the pro and con sides. We can’t use health care provider rights as a default position nor can we use the perspective of solely relying on objective means to determine what should be done. It requires an evaluation of the situation, case by case. That means that there’s no cookie cutter approach and organizations like cookie cutter because there’s certainty there and it’s less costly. But in this case, evaluating the situation on an individual basis will be the best way to move forward.