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Ethics in HTM: Part II – Going Beyond the Mission

In the current cohort of Ethics in HTM at the College of Biomedical Equipment Technology, one of our students began the first class with the following: “There are two related but distinct definitions of ethics, both involving the distinction between right and wrong, with the first rooted in personal feels, upbringing, education, or simply brain chemistry, and the second in a framework that is imposed by an external source, such as an employer or professional organization.”  The student concluded that, “[f]or most people there will be a significant but likely not absolute crossover in the paths of action that are highlighted by each of these definitions.”  That last sentence, suggested by the student’s experience in the field, is why I invariably prefer hearing directly from students rather than referring to a textbook or the OED. 

The student’s comments also identify a key challenge to some HTM professionals and HTM organizations, as well as the assumption that, simply because HTM is broadly recognized as a highly sensitive, patient-centric field, all HTM organizations and their employees will automatically establish a robust ethical environment.  However, the latter assumption is best worked towards rather than taken for granted.  Who are you as an individual?  Who are you as an organization?  Who are you as an individual within your organization?  And who are you as an organization with the values your employees bring to it?  The associated challenges can work both ways: an individual may have higher levels of ethical professionalism than the organization as much, if not as often, as the opposite.

Healthcare Technology Management is a highly regulated industry subject to intense scrutiny for adherence to some of the highest standards of any regulated industry but, for all the regulation, it has not been difficult to find case studies for the course.  Is that in part because of the “significant but likely not absolute crossover” between personal and professional ethics?  And, if so, does it evidence a failure to construct clear ethical codes within organizations or across the industry to address the potential gap?  In the healthcare field, which is otherwise well-stocked with ethics, the lack of clarity on clear ethical guidance within some HTM organizations (not all, of course) and across the industry as a whole is rather conspicuous. 

Mission vs. Ethics

When asked about ethical guidance within their organizations, most of our students who are currently working in the industry have a substantive and proud familiarity with their organization’s mission.  A well-crafted mission is of high value to any organization regardless of the profession and there are many well-crafted missions in the HTM industry.  Often, they will revolve around principles of transparency, accountability, cost savings, patient safety, healthcare accessibility, and fiduciary responsibility, but life and wellbeing are a front and center formulated priority. 

To avoid picking industry favorites, but to make a point about ethics, I will briefly share and discuss the value I see in our College’s Mission:

The College of Biomedical Equipment Technology delivers premier education and training in Healthcare Technology Management and Information Technology to equip students to meet the evolving needs of the industries we serve.” 

This is a concise statement of our identity, of who we are as an organization: it advises the public, our industry partners, and students exactly who we are and where we reside in the world of postsecondary education; it advises our faculty as to the high quality (“premier”) education to which we are committed; it advises our admissions and career services teams that our education and training has a clear career-focused, vocational objective; and it reminds our senior executive, management, and curriculum development team that we serve two populations – our students, of course, who are trained for immediate employment or upskilling  in the field, but also our industry partners who have continually and often rapidly evolving training needs. 

But a Mission is not a Code of Ethics.  That is provided by our accreditor, which holds all participating institutions subject to rigorous rules of quality and equity in educational content, delivery, enrollment processes, financial administration, governance, faculty and curricular excellence, and graduation and job placement rates, among other peer-reviewed and audited standards.  Key to this adherence is placing quality and equitable education and student success at the center of all our decision making, with corollary benefits in added accountability, responsible innovation, continuous professional improvement, and enhanced public confidence in the College as an institution.

Creating an Ethical Environment

With a review of the case study in the first blog and all other case studies in the Ethics course, ethics might seem like a formula to apply retroactively to address issues you have identified as negatively consequential to stakeholders, but ethics should be primarily a forward-thinking strategic application, not just how you review your operations but how you set them up in the first place. 

Pro-active applications can be applied to policy, operational handbooks, codes of conduct, orientation and training, and ongoing professional development to maintain high standards of ethical integrity.  And the prism through which this assessment can be framed is the same as that applied to discovered ethical breaches.  What are the principles involved?  What is the information you need to implement, protect, and serve those principles?  Who are the stakeholders involved and what consequences could result, now and in the longer term, from deviation from those principles?

Incorporating ethics as a proactive organizational tool in both policy development and training is not merely about compliance or avoiding negative consequences and the accumulation of ethical debt. It is also a strategic approach that embeds ethical principles into the fabric of an organization’s operations and culture that can quickly reap rewards.  These can include, but are not limited to:

·      Excellence in Decision-Making.  Clear ethical guidelines can guide organizations towards ensuring that every decision, from the C-suite to entry level employees, align with core values and foster consistency across the organization.

·      Creating a Culture of Integrity.  Ethical proactivity and training can cultivate an environment where integrity and transparency is valued and respected.

·      Enhanced Stakeholder Trust.  A proactively ethical organization can enhance an organization’s reputation and build loyalty among stakeholders, including customers, investors, and regulatory bodies.

·      Risk Management.  Embedding ethics into organizational practices can act as a form or risk management, preventing reputational or legal issues before they arise.

·      Sustainable Success.  A commitment to proactive ethical practices can lead to better decision-making, improved relationships with stakeholders, and a motivated workforce, all of which may contribute to long-term profitability and growth. 

·      Innovation.  An ethical environment is one in which employees are secure in expressing ideas and concerns, an openness that can lead to innovation and adaptability on the basis of enhanced feedback and capability of navigating ethical challenges. 

Of course, in an industry rife with accreditation standards, certifications, and operational interdependence, all guided towards the ultimate goal of quality care and patient safety, the benefits of high ethical standards in ensuring compliance are an inestimably valuable outcome.  But it is reassuring to be mindful that ethics are also good for business. 

Leveraging ethics as a proactive tool in policy development, training, and implementation is an investment of immediate benefit but also an investment in an organization’s future.  HTM professionals should always work to a very high standard of care and organizations should always cultivate an environment in which they are trained and trusted to do so.  And while there will always be a need for an ethical mop and broom, as it were, we can minimize the need for their use. 

As the renowned ethicist, Suan Liautaud, has succinctly noted: “Ethics are an early-stage endeavor, not an eraser or a clean-up act after harm is done.”

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