By Artur Victoria

Being a leader you have to train your skills on decision making.

Because of my extended experience I can help giving these reflection topics. I am available to develop any special need for you

This would focus on:

— Looking at some established models of ethical decision making;

— Examining and discussing cases/scenarios involving individual ethical dilemmas

— Examining the issue of Conflict of Interest from an ethical perspective

— Discussing organizational ethical climate as a factor in ethical decision making

Ethical Checklists

Example I: 12 Questions to ask yourself

1.Have you defined the problem accurately?

2.How would you define the problem if you stood on the other side of the fence?

3.How did this situation occur in the first place?

4.To whom and to what do you give your loyalty as a person and as a member of the corporation?

5.What is your intention in making this decision?

6.How does this intention compare with the probable results?

7.Whom could your decision or action injure?

8.Can you discuss the problem with the affected parties before you make your decision?

9.Could you disclose without qualm your decision or action to your boss, your CEO, the board of directors, your family, society as a whole?

10.Are you confident that your position will be as valid over a long period of time as it seems now?

11.What is the symbolic potential of your action if understood? misunderstood?

12.Under what conditions would you allow exceptions to your stand?

–Collect information and identify the problem.

–Be alert; be sensitive to morally charged situations: Look behind the technical requirements of your job to see the moral dimensions. Use your ethical resources to determine relevant moral standards. Use your moral intuition.

–Identify what yOIl know and don’t know: While you gather information, be open to alternative interpretations of events. So within bounds of patient and institutional confidentiality, make sure that you have the perspectives of patients and families as weil as health care providers and administrators. While accuracy and thoroughness are important, there can be a trade-off between gathering more information and letting morality significant options disappear. So decisions may have to be made before the full story is known.

— State the case briefly with as many of the relevant facts and circumstances as you can gather within the decision time available:

What decisions have to be made?

Who are the decision-makers?

Remember that there may be more than one decision-maker and that their interactions can be important.

Be alert to actual or potential conflict of interest situations. A conflict of interest is “a situation in which a person, such as a public official, an employee, or a professional, has a private or personal interest sufficient to appear to a reasonable person to influence the

objective exercise of his or her official duties. “These include financial and financial

conflicts of interest (e.g., favouritism to a friend or relative).

In some situations, it is sufficient to make known to all parties that you are in a conflict of interest situation. In other cases, it is essential to step out a decision-making role.

Consider the context of decision-making

1 -Ask yourself why this decision is being made in this context at this time? Are there better contexts for making this decision? Are the right decision-makers included?

Specify feasible alternatives.

2 – State the live options at each stage of decision-making for each decision-maker. You then should ask what the likely consequences are of various decisions. Here, you should remember to take into account good or bad consequences not just for yourself, your profession, organization or patients, but for all affected persons. Be honest about your own stake in particular outcomes and encourage others to do the same.

3 – Use your ethical resources to identify morally significant factors in each alternative.

— Principles: What are the principles that are widely accepted in one form or another in the common moralities of many communities and organizations.

— Moral models: Sometimes you will get moral insight from modelling your behaviour on a person of great moral integrity.

— Use ethically informed sources: Policies and other source materials, professional norms such as institutional policies, legal precedents, and wisdom from your religious or cultural traditions.

— Context: Conlextual features of the case that seem important such as the past history of relationships with various parties.

— Personal judgments: Your judgments, your associates, and trusted friends or advisors can be invaluable. Of course in talking a tough decision over with others you have to respect client and employer confidentiality. Discussion with others is particularly important when other decision-makers are involved, such as, your employer, co-workers, clients, or partners.

Your professional or health care association may provide confidential advice. Experienced co-workers can be helpful. Many forward-looking health care institutions or employers have ethics committees or ombudsmen to provide advice. Discussion with a good friend or advisor can also help you by listening and offering their good advice.

— Organized procedures for ethical consultation: Consider a formal case conference(s), an ethics committee, or an ethics consultant.

4. Propose and test possible resolutions.

— Find the best consequences overall: Propose a resolution or select the best alternative(s), all things considered.

— Perform a sensitivity analysis: Consider your choice critically: which factors would have to change to get you to alter your decision? These factors are ethically pivotal.

— Consider the impact on the ethical performance of others: Think about the effect of each choice upon the choices of other responsible parties.

Are you making it easier or harder for them to do the right thing? Are you setting a good example?

— Would a good person do this?: Ask yourself what would a virtuous person – one with integrity and experience – do in these circumstances?

— What if everyone in these circumstances did this?: Formulate your choice as a general maxim for all similar cases?

— Will this maintain trust relationships with others?: If others are in my care or otherwise dependent on me, it is impoltant that I continue to deserve their trust.

— Does it still seem right?: Are you and the other decision-makers still comfortable with your choice(s)?

If you do not have consensus, revisit the process. Remember that you are not aiming at Uthe” perfect choice, but a reasonably good choice under the circumstances.

5. Make your choice.

Live with it and Learn from it: This means accepting responsibility for your choice. It also means accepting the possibility that you might be wrong or that you will make a less than optimal decision. The object is to make a good choice with the information available, not to make a perfect choice.

Learn from your failures and successes.

— Accepting a gm In return for organizational favors

— Peddling influence for a fee or for personal gain

— Insider trading

— Nepotism

— “Moonlighting” (some situations)

— Industrial relations activities

Often discussed in respect of “public duty” and public employee responsibility, but in fact goes to every sector of employment.

The potential benefits emanating from such a conflict can extend beyond the individual, to family members, business associates, friends etc.

Private activities as conflicts of interest

Rightly or wrongly, private activities can be seen as in conflict with organizational duty, even if not yielding monetary advantage, as potential causes of public embarrassment or diminishing

faith in tlre integrity of the individual and/or the organization.

Examples

— Social and business contacts

— Lifestyle “idiosyncrasies”

— Behavioral predilections (sexual 7)

— Activities of partners

— Use of substances (alcohol, drugs 7)

— Personal financial arrangements

— Political or Religious affiliations

Conflicts of Interest: Issues for resolution

What should be the major focus of our concern?

— Is it reasonable to require avoidance of you by employees ?

— To what extent are private lives relevant to organizational life ?

— What conditions need to be fulfilled to established that a C or I exists ?

— Should we allow the media or public opinion to dictate what is or is not a Col ?

— Is it appropriate to include spouses, family members, friends, business associates etc. in considering C of I ?

— Should people be required to declare their interests ?

Conflict of Interest

The ethical responsibility to ensure that our private interests do not interfere with the proper

accomplishment of our organizational duties.

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