Practical Ethics

I thought you might be interested in playing a game called 'practical ethics'. Once a month or so, AHA poses a fictitious ethical dilemma to its magazine readers. First, you read the question. Then take a minute to think about what you would do. Then you compare your thinking to two opposing responses from hospital CEOs.

I thought I would share this question on patient privacy - that's a bit different than what we have been discussing, but I thought I would leave you with something a little less profound to grapple with - ethics in the trenches.

QUESTION:
Two members of your staff took photos with cell phone cameras of patients in the emergency room. The photos were later posted on the Internet on social networking sites. Since then, you’ve dismissed the employees who were responsible, and it appears that the patients were unrecognizable in the photos. Still, there is concern in your organization that this could happen again—and potentially lead to HIPAA violations—and some think you should ban staff from having cell phones outside of employee-only areas as a precautionary step. What should you do?

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Doug Vinsel, CEO, Duke Raleigh (N.C.) Hospital
The action taken has to be balanced and proportionate to the problem at hand. Certainly the scenario described is one that creates the potential for institutional embarrassment and liability. The dismissal of the employees involved and the presumed apologies to the patients/families is appropriate. While the thought of banning cell phones outside of employee-only areas is an understandable reaction, it is, I believe, an overreaction and an impractical way to address the misconduct of two employees. Employee education around the proper use of cell phones should be a requirement for department managers to ensure staff understanding of appropriate usage. However, the vast majority of staff can be trusted to use cell phones appropriately and understand the consequences of not doing so. We want to build a culture of trust and treating one another and our patients respectfully. Establishing a ban on cell phones is contrary to those principles.

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Anthony Spezia, CEO, Covenant Health, Knoxville, Tenn.
We absolutely support and wholeheartedly agree with the terminations of the two employees. This is a clear violation of our corporate compliance program, code of conduct and our standards of behavior. I would not place the ban on staff. Our values are incorporated into our strategic plan, are utilized in many internal and external communications and are all approved by the board of directors. This is not a matter of compliance; it is a matter of conviction, faith and trust. If our culture is to be strong, we must trust employees to do the right thing in clear cases where a situation is covered by our policies and standards. This is such a case, and we would not support banning cell phones solely for the purpose of enforcing an articulated policy. We would not violate our employees’ trust, nor would we diminish their commitment to act according to our norms by taking away their cell phones. Rather, we would trust them and our strong culture of accountability.

This article 1st appeared in the November 2008 issue of HHN Magazine.
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