Healthcare is growing ever more complex as emerging technologies challenge us in new ways. Rapid deployment of breakthroughs such as generative artificial intelligence and quantum computing have raised ethical questions about accuracy, equity and accountability, to name a few concerns. Thinking through the ramifications of incorporating these innovations adds to the myriad ethical considerations that healthcare leaders already face, from striking the delicate balance between patient care and business needs to addressing poor behaviors.
With our decisions drawing more scrutiny than ever before, our commitment to leading ethically has perhaps never been more important. That commitment has been a core part of our profession since ACHE’s founding 90 years ago. It also is a vital part of our mission at ACHE, where we ask all members to attest annually that they will adhere to our Code of Ethics and the standards of ethical behavior described there.
Given today’s complexities, ethics in our field is always evolving—a living, breathing construct rather than a static guideline. That’s why we review and update the Code every year to ensure it continues to serve as a relevant standard of conduct for our profession. By holding ourselves accountable and having good systems in place, we can ensure that our decisions are those that merit the trust, confidence and respect of our colleagues and all those we serve.
However, our ethical obligations as leaders oftentimes require more. The Code lays out the responsibilities we have in our professional relationships and individual behavior, three of which may be helpful to consider.
Responsibilities to the profession. We are of course expected to conduct professional activities with honesty, integrity, respect, equity, fairness and good faith, and in ways that reflect well upon our profession. We also have a duty to address situations in which we believe a leader has violated the Code in some way, and share the facts about it with the ACHE Ethics Committee. Reporting a peer or colleague can be difficult and takes courage, but it is a responsibility we have as leaders.
Responsibilities to our organization. Our obligations here are many, chief among them being prioritizing patient care above all other considerations. They also include implementing an ethical framework for our organization, including establishing conflict of interest principles and whistleblower protections, and ensuring that competent and effective ethics resources and mechanisms are available for staff, patients and families to address any organizational and clinical issues that cross ethical lines.
Responsibilities to those we serve. As leaders, we work in service to many—patients, the community, our staff. Key parts of our responsibilities to them are to treat everyone with respect, equity and dignity. We also have an obligation to build trust. For patients and the community, that can be in the form of working to support access to care for everyone while addressing factors influencing social determinants of health that can affect access. For our staff, it means providing a safe, healthy and equitable work environment that encourages free expression of ethical concerns and provides effective mechanisms for discussing and addressing such concerns.
These are just a few takeaways from the Code. ACHE’s Ethics Policy Statements go deeper by addressing specific ethical issues in healthcare. In addition, our Ethics Self-Assessment can help you think through your own ethics-related leadership and actions. And our Ethics Toolkit and a set of ethics resources are available at ache.org/Ethics.
As ACHE’s core value of integrity reminds us, each leader is responsible for their own ethical conduct, and there is no one asset as powerful and fragile as how we demonstrate these tenets in our relationships and work. It is the core of how we are defined as leaders.
Today’s ethical issues may be increasingly thorny and complicated, but we are here to assist as you navigate them and work to best serve those who put their trust in you.
Deborah J. Bowen, FACHE, CAE, is president/CEO of the American College of Healthcare Executives (dbowen@ache.org).