Ethics—Walk the Talk

Kathleen C. Niedert, PhD, RD, CSG, LDIowa Dietetics in Health Care Communities

April 25, 2014

Ethical Lines Do Exist

• Lying• Cheating• Stealing

Why Bend the Rules?

“I do it so that I get a good outcome. It doesn’t hurt to bend a (policy) (regulation) (law) (rule) if you get a good outcome”

Every day we have those “gray” areas

• Client-related decisions• Practicing beyond a person’s qualifications, capabilities, education, or experience• Providing both sides of an issue

• Appropriate business practices• Clinical

• Billing and proper use of health care resources• Appropriate advertising services

“Gray” Areas where ethics comes into play

• Appropriate business practices (cont.)• Food Service

• Rebates• Human resource decisions

• Relationships with professionals, customers and employees• When a conflict of personal interest may be involved if self-disclosure of a

relationship is not revealed• Covering up a substance abuse problem

Ethics is the Struggle Between…

“Right & Wrong”

“Moral & Immoral”

“Just & Unjust”

Ethics: (eth/iks)

1. The study of standards of conduct and moral judgment.

2. The study of the general nature of morals and of the specific moral choices to be made by a person.

3. The rules or standards governing the conduct of a person or the members of a profession.

Ethics

The code of moral principles and values that govern the behaviors of a person or group with respect to what is right or wrong.

Influence on Personal Ethics

People

Your family played a large part in shaping your personal ethics.

Your family member and friends exert strong influence on your ethics.

Teachers, especially when you were younger, may have laid the foundation for ethical decisions.

Influence on Personal Ethics

Culture

Culture is an integral part of every society.

It is a learned pattern of behavior and ways in which a person lives his or her life.

Culture is essential for the existence of a society, because it binds people together. In the explicit sense of the term, culture constitutes the music, food, arts and literature of a society. Culture is way of life.

A culture is a way of life that is based on beliefs and values, such as art, food, dance, rituals, religion, etc

Influence on Personal Ethics Culture Culture is an integral part of every society.

It is a learned pattern of behavior and ways in which a person lives his or her life.

Culture is essential for the existence of a society, because it binds people together. In the explicit sense of the term, culture constitutes the music, food, arts and literature of a society. Culture is way of life.

A culture is a way of life that is based on beliefs and values, such as art, food, dance, rituals, religion, etc

Influence on Personal Ethics Law

Laws, some argue, represent the minimum standard of behavior.

Law is a set of rules in society set by the government in order to maintain control.

Law of state has much and more influence one personal ethics.

Acting ethically mean following the law.

Influence on Personal Ethics Law

Laws, some argue, represent the minimum standard of behavior.

Law is a set of rules in society set by the government in order to maintain control.

Law of state has much and more influence one personal ethics.

Acting ethically mean following the law.

Influence on Personal EthicsReligion Religion is belief in super natural and divine power or powers and

how we relate to them. It comprises belief and practice.Religious traditions give instructions to followers about what’s right

and wrong. That is, belief systems define what is or isn’t ethical. In some religions, unethical behavior is punished and ethical

behavior is rewarded. In other religions, teachings provide guidelines for ethics, but leave latitude for the believer to interpret what is ethical and what isn’t

Criteria for Ethical Decision Making• Most ethical dilemmas involve A conflict between needs of the part & whole.The individual versus the organization. The organization versus society as a whole.

Background to Ethical ContextAn Ethical dilemma is a complex situation that often involves

an apparent mental conflict between moral imperatives, in which to obey one would result in transgressing another. This is also called an ethical paradox.

Making ethical decisions is relatively easy when all the facts of a situation are known.

Background in Ethical Context

Ethics As a Communication Issue

We communicate our values and beliefs t others via verbal and nonverbal behavior

We are defined in the eyes of others according to the way we behaveWe also need to communicate to others the importance and necessity of

good ethics

It follows that we have a responsibility to act in ways that promote honest and fairness to maximize the personal worth of each person in the organization

Background to Ethical ContextEthics in Corporations – A Historical ViewCompanies have long fought the battle of corporate corruption. Because

corporations are run by people and no human being is morally perfect, ethical issues are bound to arise. How these issues are handled is the best indicator of a corporation’s ethical commitment. Establish ethically moral behavior in your corporation by taking the task seriously.

When company executives behave unethically, that behavior often ends up in the news. While most companies have ethics policies, they don't necessarily enforce or even follow them. By incorporating ethics into the very heart of the business and reinforcing the idea of ethical behavior, businesses can run efficiently, legally and ethically.

Communication and Ethical Issues Key Areas for Ethical

CommunicationKey areas for ethical communication

Ethical treatment of a subject takes time, thought, and preparation. As a professional, it is important for you to focus on ethical communication in three key areas:

Personal Written and Spoken Messages

Cross-Cultural Messages

Advertising Messages

Communication and Ethical Issues

Personal Written and Spoken Messages

Your messages, both written and spoken, demonstrate not only the message, you intended but also a message regarding your values and integrity.

Use these guidelines to evaluate your purpose and motives in each situations.

The guidelines are:1.Message purpose2.Research methods3.Selection of material4.Development of ideas5.Use of language6.Ethical context7.Self-analysis

Communication and Ethical Issues Key Areas for Ethical

CommunicationCross-Cultural Messages

Never before have so many people from different cultures lived and worked together.

The world has become a global village, and the work force reflects that diversity. Because we have such different customs and ways of communicating, it is natural that misunderstandings occur in the workplace.

The cross-cultural ethical outline will help you assess your ethicality in multicultural situations.

Cross-Cultural Ethical Guidelines:1.Cultural context2.Misunderstandings3.Language4.Accountability

Communication and Ethical IssuesKey Areas for Ethical

CommunicationAdvertising Messages

It is ethically wrong to advertise products in ways that confuse. Whether promoting a college jazz event, a gateway weekend, or a line of products for a multimillion dollar company, the rule for ethical advertising is consistent:

Tell the truth, don’t misrepresent , and don’t manipulate language to create a false impression.

Ethical Guidelines for Advertising:1.Language2.Graphics/print3.Omission4.Truth5.Accountability

Communication and Ethical Issues

Ethics and Organizational Responsibility

Business corporations exists for one reason: to make money . Today, however, corporations are mindful of their corporate social responsibility, or CSR (Corporate Social Responsibility), also known as their "triple bottom line," which includes a concern for profits, but also an ethical treatment of people and the world in which we live. Proponents of CSR models say that businesses are actually more profitable when they employ high CSR standards, but that idea is still disputed by some corporate and financial analysts.

1.Environment2.Human Rights3.Community Development4.Employee Welfare

Three Pillars of an Ethical Organization

SOURCE: Adapted from Linda Klebe Trevino, Laura Pincus Hartman, and Michael Brown, “Moral Person and Moral Manager,” California Management Review 42, No. 4 (Summer 2000), 128-142.

The Academy’s/CDRs Code of Ethics

A compass for ethical conduct

Types of Codes

•Aspirational

•Educational

•Regulatory

The Code consists of Five Categories

1. Fundamental Principles

2. Responsibilities to the Public

3. Responsibilities to Clients

4. Responsibilities to the Profession

5. Responsibilities to Colleagues and Other Professionals

Nineteen Principles

Functions of the Code of Ethics

The code is intended to:

• Protect the profession and the credential

• Influence public and private policy

• Improve professional practice

• Educate dietetics practitioners about ethical decision making

• Meet the guidelines of the accrediting agency for the Commission on Dietetic Registration

Misconceptions about the Code of Ethics

The Code is not intended to:

• Identify and reprimand all unqualified dietitians and dietetic technicians

• Be a punitive force to take away credentials

The Code of Ethics

Accessing the Code

• Journal of the Academy of Nutrition and Dietetics, August 2009, pages 1461-1467.

• Academy Web site – www.eatright.org/codeofethics

Ethics Requirement

• Current published Professional Development Portfolio Guide for Cycles Ending 2019 includes the requirement of a minimum of 1 CPEU in ethics, effective with the 5-year recertification cycle which ends May 31, 2017.• Must meet Learning Need Code 1050• A number of resources available to meet requirement

Tools & Resourceswww.eatright.org/codeofethics

• Ethics Committee• Ethics Team at Headquarters• Ethics For Further Reading List• FNCE sessions*• Ethics Opinions*• Ethics in Action columns*• Ethics Case Studies*

• Impact of Social Media on the RDN and DTR (NEW)• Case Studies and Discussion Question for Ethics Video Series*• Ethics Video Series*

Access to the Ethics Committee

• Any member or non-member can make a complaint.

• Complaints are not anonymous but are confidential.

• If a complaint is made, it is forwarded to the member for a response.

• The Ethics Committee then reviews the complaint and discusses the response in executive session.

Ethics Case Management Procedure

• The enforcement procedures are intended to permit a fair resolution of disputes on ethical practices in a manner that protects the rights of individuals while promoting understanding of ethical practice.

• The Ethics Committee has the authority and the flexibility to determine the best way to resolve a dispute, including educational means where appropriate.

What happens next…

• Case may be dismissed

• Further information may be requested

• Person may be contacted with specific actions for educational intervention

What happens next…

• Membership in the Academy of Nutrition and Dietetics may be censured, placed on probation, suspended, or revoked

• RDN or DTR credential or specialist credential may be suspended or revoked

• Ethics Committee uses a defined policy and procedure handbook to guide its decisions.

Ethical Issue or Not ?

• Legal, regulatory, or ethical issue?

• Employer policy issue?

• Personal issue?

• Business dispute?

• Academy/CDR member issue?

• If violation of the Code violation-cite principle violated

Recent Complaints# Inquiries # Complaints Complaint Types

8 1 Personal dispute

15 5 Inappropriate advice (3); Practice without a license; Copyright violation

16 6 Inappropriate advice; Personal dispute; Poor business practice (4)

24 11 Poor business practice (5); Licensure violation (4); Lack of scientific support; Legal violation

18 5 Personal dispute; Lack of scientific support (2); Misuse of RDN, Poor business practice