holy family hospital | mount saint joseph hospital | st. paul’s hospital | st. vincent’s...

32
Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence | Marion Hospice Organizational Ethics Organizational Ethics Thomas D. Maddix, CSC, D.Min. Vice President, Mission, Ethics & Spirituality

Upload: ginger-wade

Post on 26-Dec-2015

216 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence | Marion Hospice

Organizational EthicsOrganizational Ethics

Thomas D. Maddix, CSC, D.Min.

Vice President, Mission, Ethics & Spirituality

Page 2: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Organizational Ethics

“We saw nothing not because there was nothing, but because we had trained ourselves not to see.” Richard Garry, a character in Colm Toibin’s novel, The Story of the Night

  Any organization of work--industrial, service,

blue or white collar-can be described as a psychostructure that selects and molds character. Michael Maccoby, The Gamesman

Page 3: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Definitions

• Disciplined process for incorporating ethical reflection and practices into the life and work of an organization.

• Organizational Ethics is the intentional use of values to guide the decisions of a organization. Providence Health Care, Vancouver

• Organizational ethics examines the ethics of the (health care) organization as a whole.

Page 4: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Definitions

• It asks: What is the organization's ethical responsibility to patients and families, the wider community, employees, and other stakeholders?

• Organizational ethics considers the actions of individuals insofar as the organization they represent is affected by—or shares accountability for—their conduct. E-ethics park Ridge Centre

Page 5: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Definitions

•     Has to do with the identity and the integrity of the organization itself—with who the organization is and becomes and with what the organization does. The organization's character and behavior, these are the concerns and the scope of organizational ethics.

(Ron Hamel, PhD Health Progress, Dec.2006)

 •      It requires that the organization's values permeate the

organization at all levels and in all areas—from executive leadership to housekeeping; in planning, budgeting, and all other decisions; in policies,

procedures, and practices; in internal and external relationships. Ron Hamel, Ph.D Health Progress, Dec. 2006

Page 6: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Common organizational ethics issues include:

1. Business and Service Plans (mergers, partnerships, contracts with providers, marketing etc.)

2. Quality and Safety Issues

3. Employee Rights and Responsibilities (compensation, bargaining, diversity, harassment, privacy)

4. Role in the Community (advocacy, investment policies)

5.  Resource Allocation

6. Work Restructuring

Page 7: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Issues continued:

7. Charitable fundraising

8. Disagreement over treatment decisions

9.  Access to care

10.  Business development

11.  Disclosure of risk

12. Business and Professional Integrity (performance review/management; conflicts of interest; incentives; hiring and promotion

13.   Other????

Page 8: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Ethics Agenda requires:

1.     People with knowledge, character and skills 2.     Experiences that impart knowledge, provide

experience and touches the souls of individuals and groups.

 3.     Tools that outline a decision-making process,

publications/documents that enhance the discussion of key issues and

codes/guidelines.

Page 9: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Ethics Agenda requires:

    4. Becoming clear about what ultimately drives our decision-making demands knowing the fundamental difference between the espoused and the operative values of an organization. (Gordon Self…unpublished paper, 29 December 2008)

  5. “A deliberate choice and use of criteria rather than

letting these operative values comes from external pressure or emerge amorphously from a general context of corporate culture.” Charles McCoy, p. 241, Management of Values

   

Page 10: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Ethics Agenda requires:

6. A culture which 

• Places ethical issues on the agenda•  Provides a safe place to discuss conflicting

ethical concerns•   Has a process for handling ethics disputes

Page 11: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

The Root of Moral Conflict within organizations: Where we are coming from . . .1.     Perceptions different…often the same

value 2.     Different ways of seeing the same

issue/experience 3.     Different educational and vocational

environments 4.     Different metaphors/images that shape

our images of a moral issue

Page 12: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

The Root of Moral Conflict within organizations: Where we are coming from . . .

5.      Different images of ourselves, of others, of society, of the natural world and

whatever God or centre of loyalty that provides us with integrity.

 6.      Different worldviews, ideologies or

stories that provide our lives/organizations setting and viewpoint.

 7.      Different life experiences

Page 13: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

History

HopesNeeds Interests

IntentionsBeliefs

Fears

Assumptions

Feelings

Worldview

Perceptions

Unresolved Personal or Group Traumas

Individual Experiences

Group/CulturalHistory

Behaviour

RolesSkin Colour

Values

“Explicit”

“In-awareness”

“Implicit”

“Out of awareness”

Visible

Invisible

Page 14: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

The Root of Moral Conflict within organizations: Where we are coming from . . .

8.     These experiences/ lenses give us eyes to see some things but not others.

 

9.      To begin to address ethical issues, important to “know where we are coming from,” and “where in the world we are”…as moral interpreters, evaluators, decision-makers and actors.

Page 15: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

The Root of Moral Conflict within organizations: Where we are coming from . . .

10.     Stanley Hauerwas has stated, “moral behaviour is an affair not primarily of choice but of vision.”

 11. To see is to behave

 

12. Morality is based on who we are as viewers and our interpretation of what is going on.

Page 16: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Institutional Contexts of Doing Ethics

1.     An institution: any significant or established practice, relationship or organization (The way we do things around here!”)

 2.     “Organizations become institutions as they

are infused with value, that is, prized not as tools alone but as sources of direct personal gratification and vehicles of group identity.” Philip Selznick p. 67 in Management of Values by Charles McCoy

Page 17: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Institutional Contexts of Doing Ethics

3.     The organizations/institutions provide us with places– to be– to see– points of contact with ethical questions– points of view for moral/ethical insight– context by which we live our ethical

vision

 

      

Page 18: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Leaders and Culture - What’s important

• What leaders pay attention to, measure and control on a regular basis.

• How leaders react to critical incidents and organizational crises

• Observed criteria by which leaders allocated resources.

Page 19: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Leaders and Culture continued

• Deliberate role modeling, teaching and coaching.

• Observed criteria by which leaders allocate rewards and status.

• Observed criteria by which leaders recruit, select, promote, retire and ostracize organizational members. Ron Hamel, quoting from work done by the VA

in the USA.

Page 20: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Fear and the impact on Organizations and Ethical Dialogue

Fear of:         failing        being misunderstood        losing our position

Page 21: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Fear Continued

             job loss        failure        image or status loss         not living up to

expectations-self/others

Page 22: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Fear continued

• protects us from what may challenge or change us

• loss of control . . . Relationships

• loss of identity

• conflict

Page 23: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Fear continued

•   looking foolish in front of our peers…results in a paralysis of self, others and organization

• our ignorance and prejudices exposed •  People disengage and ‘deferential

thinking’ becomes the norm (Gordon Self, ibid)

Page 24: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Roles in organizations can:

       Corrupt us badly as our uncritical loyalty to them does (puppets or parrots)

 

        Give us leave to dehumanize others

 

 

        Dehumanize ourselves

Page 25: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Roles in organizations can:

        Keep us in line and prompt us to discharge obligations that we might otherwise neglect.

         Facilitate communication, helpfulness

and productivity.         Ethical Responsibility in institutional

life…requires paying attention to the implications of ethical behaviours for

specific roles.

Page 26: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Moral Character in Organizations:

1.     Occurs when an organization is committed to values and shapes it future and life

according to them. 2.     The basic values or beliefs that guide the

culture at either the conscious or unconscious life give “character” to the culture.

 3.     Corporation/organization is a moral agent

Page 27: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Moral Character in Organizations:

4.    Decisions made within the context of the organization impacts the lives of many people.

 

5.      The Boeing Company says, “Ethics should be approached as a system issue and not as a problem of ‘bad individuals.’”

 

6.      Yet, there are individuals around the table making decisions…

Page 28: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Key Points for us to consider:

1.    We live in institutions and institutions live in us

 2.     Moral and ethical development occurs

not only for the individual but also for the community and organization

 3.     Moral/Ethical responsibility means being

responsible people but also making our organizations more responsible.

Page 29: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Key Points for us to consider:

4.      We need to learn how systems, structures, cultures and institutional character can be changed.

 

5.      Only to the extent that we hear other voices and see from other vantage points can we see around the blinders that our personal (inner and outer) locations impose.

Page 30: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Key Points for us to consider:

6. For us to “do ethics,”---to reflect critically on the character and action of ourselves and our communities—we must recognize ‘where we are” and “where we come from.”

Page 31: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Concluding Considerations:

Organizational integrity doesn't just happen. Achieving and maintaining it require sustained attention and ongoing efforts. It is hard work…To the extent that who the organization claims to be is not expressed in what it does in its daily activities, there is something lacking at its core. It lacks "wholeness."

Ron Hamel, Ph.D Health Progress, Dec. 2006

 

Page 32: Holy Family Hospital | Mount Saint Joseph Hospital | St. Paul’s Hospital | St. Vincent’s Hospitals: Brock Fahrni, Langara, Heather | Youville Residence

Concluding Considerations:

Authenticity and integrity or inner harmony are related to the choices

made on the basis of who we are and what we love.

Jean S. Bolen, MD, The Ring of Power