Exhibiting and Promoting Ethical Decision Making in Public Health and

Administration

August 18th, 2020

Dr. Adam Brewer, Assistant ProfessorDepartment of Public Administration and Policy

University of Montana

Learning Objectives

By the end of this session, we will…• Define key terms and definitions related to ethics and ethical practices• Understand the principles and values of ethical practice in public

administration• Be able to identify ethical dilemmas in public health settings • Be able to apply ethical frameworks to solve ethical dilemmas and analyze

the implications of selecting one alternative over another• Learn how to promote and foster a culture of ethical decision making in

one’s organization

Thought Activity

• Write down one phrase where you describe what acting ethically looks like in your particular job. Take 30 seconds.• Using the comments function in Zoom, share with us your answer.

Responsibilities

Fiduciary Responsibility (Callaghan, 2016)o Public health administrators are stewards of limited public resources

and should strive to use those resources wiselyo The beneficiary has delegated authority to the fiduciary to act

on its behalfo The fiduciary has discretionary powers over the beneficiary’s

assets or interestso The fiduciary is in a position superior to that of the beneficiary

due to specialized access, knowledge or abilityo The beneficiary trusts that the fiduciary will act in the

beneficiary’s best interest. (Ponet & Leib, 2011.)

Responsibilities

Fiduciary Responsibility (Callaghan, 2016)o The Duty of Careo The Duty of Loyaltyo Duty of Impartiality o Duty of Accountabilityo Duty to Maintain Public Trust in Government

Mini Case

You are the economic development director for a city government. The city council and mayor are both pursuing an economic development project. You are a member of the Democratic Party and you regularly participate in party activities (allowed under the Hatch Act). Members of the Democratic Party approach you asking you to oppose the economic development plan.

The Challenge

Competing Loyalties

The Public

OrganizationPolitical

Superiors

What is Ethics?

General Definition:

Ethics refers to well-based standards of right and wrong that prescribe what humans ought to do, usually in terms of duties, principles,

specific virtues, or benefits to society (consequences).

What is Ethics?

Ethical, moral, and legal distinctions:Ethical- Ethics refers to well-based standards of right and wrong that prescribe what humans ought to do, usually in terms of duties, principles, specific virtues, or benefits to society (consequences).

Moral-Distinctions made between right or wrong and good or evil. Generally related to a reflection of the values of society, religion, ethnic or social group, or of individual conscience

Legal- Within the province of the law. When something is allowed or forbidden by the law.

Four Dimensions

DUTIES VIRTUES PRINCIPLES CONSEQUENCES

Certain obligations assumed when taking

on a role or profession. The behaviors that are expected of those who

occupy a role.

Various characteristics that define what a good person is.

Fundamental truths that form the basis for

behavior. Types of actions that are right or

obligatory.

Actions that produce the greatest good for the greatest number.

Duties

o Duty-“old fashioned”o Narrowly, it implies restricted actions one is

required to take (constrained by external controls)

o Duty means actions “required by one’s business, occupation, or function” and/or legal obligation

o For you, duty has special importance…o (1) Serve the public, (2) fulfill expectations, (3)

and be trustees of public resourceso What are the expectations of persons serving

as public servants?

Virtues

Expanding Duty-Based EthicsWhat are the qualities of a good person?o Public servants should…o Display honesty (integrity, reliability, loyalty)o Be respectful (civility, courtesy, decency, caring)o Be responsible (accountable, self-restraint) o Be fair (follow process, impartiality, equity)o There are many virtue lists depending on time and context

Principles

What is the right thing to do?o Follow the laws, policies, or regulationso Treat everyone equallyo Be fair in your actionso Do not lieo Follow the Golden Ruleo Protect confidential informationo Avoid improprietyo Share and disclose information to the public

Consequences

What is the most beneficial action to take?o Public servants should try to obtain the greatest good for the

greatest number of people.o An action is right or wrong depending on it consequenceso Example: Trolley Experimento Do you break the rules to get good results?o Public servants should be committed to producing positive

outcomes.o Goals: (1) Improving the welfare of society (2) Increasing happiness

of individuals

The Ethics Triangle

DutyPublic Interest

CharacterVirtue/Intuition

PrincipleJustice/ Fairness/Equity

Greatest GoodConsequences

Codes of Ethics

o Codes of ethics are statements that define the duties of public servants, the virtues they should hold, the certain principles espoused by employees of their organization, and the outcomes if ethical principles are followed.o Does your organization have one? o Do you know what it says? Hopefully!

Codes of Ethics

Other Codes of Ethics:o American Society for Public Administration Code of Ethics

(APSA)o Principles of Ethical Practice of Public Health, Public Health

Leadership Society (PHLS)o Code of Ethics for Nurses, American Nurse Association

(ANA)o Code of Ethical Conduct, The National Association for the

Education of Young Children (NAEYC)

Codes of Ethics

o Side Note: Codes of ethics may encourage pubic servants to follow the law and public policy

o What’s legal may not be ethical, what’s ethical may not be legal

o Examples:o Lying to your boss to get the day off of

worko Providing an unruly patient with

misinformation to pacify themo Some use medicinal marijuana even

though it is illegal in some states

Ethical Decision Making

Ethical Responsibilitieso Mandates that are clearly spelled out in your organization’s code of

ethics (the do’s and don’ts)o In following the mandates, you can refer to them when making

unpopular decisionsEthical Dilemmaso An ethical issue that doesn’t involve a responsibility. A situation

with two (or more) possible resolutions (both can be justified using ethical principles)

o Both options have costs and benefitso Some groups/individuals will bear the costso Can rarely be resolved quickly by applying simple rules. Don’t have

clear answers. Deliberation is required.

Mini Case

You work as a contract agent for a public (government) agency. You have just negotiated a five-year contract for your agency with a computer firm that will handle all computer maintenance issues. The owner of the computer firm gives you three front row tickets to a NBA game featuring Denver Nuggets versus Portland Trail Blazers. Your daughter would be thrilled to watch the game. Do you take the tickets? Is there a conflict of interest since the contract has already been signed?

1. Is this an ethical dilemma?2. Would you take the tickets or not?3. What aspects of ethics do you consider in addressing this case?

Final Thoughts

o Ethical decision making starts with you!o Consider:o What are my duties as an employee of my organization?o What virtues should I have?o What principles should I operate from?

o What are considered the best outcomes for my work? o Locate your organization’s code of ethics, read it, and

commit to using ito Promote ethical decision making in your organization by

sharing and living components of the ethics triangle

Thank You

Sources

Sources and suggested readings:1. ASPA Code of Ethics. 2011. Retrieved from: https://www.aspanet.org/ASPADocs/ASPA%20Code%20of%20Ethics-2013%20with%20Practices.pdf2. Daniels, Norman. 2016. Public Health Ethics: Cases Spanning the Globe.3. Feeney, S. & Freeman, N.K. 2016. Ethics and the Early Childhood Educator, Second Edition4. Feeney, S. & Freeman, N.K. 2016. Focus on Ethics: Ethical Issues—Responsibilities and Dilemmas. 5. NAEYC Code of Ethical Conduct and Statement of Commitment. 2011. NAEYCRetrieved from: https://www.naeyc.org/sites/default/files/globally-shared/downloads/PDFs/resources/position-statements/Ethics%20Position%20Statement2011_09202013update.pdf6. Public Health Leadership Society. 2002. Principles of the Ethical Practice of Public Health. Retrieved from: https://www.apha.org/-/media/files/pdf/membergroups/ethics/ethics_brochure.ashx7. Svara, James. 2015. The Ethics Primer for Public Administrators in Government and Nonprofit Organizations, Second Edition