Ethical Self-Assessment Paper
cadvad
ethics_self-assessment.pdf
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 1/15
Ethics Self-Assessment
Purpose of the Ethics Self-Assessment
Affiliates of the American College of Healthcare Executives agree, as a condition of
membership, to abide by ACHE’s Code of Ethics. The Code provides an overall
standard of conduct and includes specific standards of ethical behavior to guide
healthcare executives in their professional relationships.
Based on the Code of Ethics, the Ethics Self-Assessment is intended for your
personal use to assist you in thinking about your ethics-related leadership and
actions. It should not be returned to ACHE nor should it be used as a tool for
evaluating the ethical behavior of others.
The Ethics Self-Assessment can help you identify those areas in which you are on
strong ethical ground; areas that you may wish to examine the basis for your
responses; and opportunities for further reflection. The Ethics Self-Assessment
does not have a scoring mechanism, as we do not believe that ethical behavior can
or should be quantified.
How to use this self-assessment
We hope you find this self-assessment thought-provoking and useful as a part of
your reflection on applying the ACHE Code of Ethics to your everyday activities.
You are to be commended for taking time out of your busy schedule to complete it.
Once you have finished the self-assessment, it is suggested that you review your
responses, noting which questions you answered “usually,” “occasionally” and
“almost never.” You may find that in some cases an answer of “usually” is
satisfactory, but in other cases such as when answering a question about protecting
staff’s well-being, an answer of “usually” may raise an ethical red flag.
We are confident that you will uncover few red flags where your responses are not
compatible with the ACHE Code of Ethics. For those you may discover, you should
About ACHE
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 2/15
use it as an opportunity to enhance your ethical practice and leadership by
developing a specific action plan. For example, you may have noted in the self-
assessment that you have not used your organization’s ethics mechanism to assist
you in addressing challenging ethical conflicts. As a result of this insight you might
meet with the chair of the ethics committee to better understand the committee’s
functions, including case consultation activities, and how you might access this
resource when future ethical conflicts arise.
We also want you to consider ACHE as a resource when you and your
management team are confronted with difficult ethical dilemmas. In the About
ACHE area, you can access an Ethics Toolkit, a group of practical resources that
will help you understand how to integrate ethics into your organization. In addition,
you can refer to our regular “Healthcare Management Ethics” column in Healthcare
Executive magazine, and you may want to consider attending our annual ethics
seminar.
Please check one answer for each of the following questions.
Almost Never/Occasionally/Usually/Always/Not Applicable
I. Leadership
I take courageous, consistent and appropriate management actions to overcome
barriers to achieving my organization’s mission.
Almost Never Occasionally Usually Always N/A
I place community/patient benefit over my personal gain.
Almost Never Occasionally Usually Always N/A
I strive to be a role model for ethical behavior.
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 3/15
Almost Never Occasionally Usually Always N/A
I work to ensure that decisions about access to care are based primarily on
medical necessity, not only on the ability to pay.
Almost Never Occasionally Usually Always N/A
My statements and actions are consistent with professional ethical standards,
including the ACHE Code of Ethics.
Almost Never Occasionally Usually Always N/A
My statements and actions are honest even when circumstances would allow me
to confuse the issues.
Almost Never Occasionally Usually Always N/A
I advocate ethical decision making by the board, management team and medical
staff.
Almost Never Occasionally Usually Always N/A
I use an ethical approach to conflict resolution.
Almost Never Occasionally Usually Always N/A
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 4/15
I initiate and encourage discussion of the ethical aspects of management/financial
issues.
Almost Never Occasionally Usually Always N/A
I initiate and promote discussion of controversial issues affecting
community/patient health (e.g., domestic and community violence and decisions
near the end of life).
Almost Never Occasionally Usually Always N/A
I promptly and candidly explain to internal and external stakeholders negative
economic trends and encourage appropriate action.
Almost Never Occasionally Usually Always N/A
I use my authority solely to fulfill my responsibilities and not for self-interest or to
further the interests of family, friends or associates.
Almost Never Occasionally Usually Always N/A
When an ethical conflict confronts my organization or me, I am successful in
finding an effective resolution process and ensure it is followed.
Almost Never Occasionally Usually Always N/A
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 5/15
I demonstrate respect for my colleagues, superiors and staff.
Almost Never Occasionally Usually Always N/A
I demonstrate my organization’s vision, mission and value statements in my
actions.
Almost Never Occasionally Usually Always N/A
I make timely decisions rather than delaying them to avoid difficult or politically
risky choices.
Almost Never Occasionally Usually Always N/A
I seek the advice of the ethics committee when making ethically challenging
decisions.
Almost Never Occasionally Usually Always N/A
My personal expense reports are accurate and are only billed to a single
organization.
Almost Never Occasionally Usually Always N/A
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 6/15
I openly support establishing and monitoring internal mechanisms (e.g., an ethics
committee or program) to support ethical decision making.
Almost Never Occasionally Usually Always N/A
I thoughtfully consider decisions when making a promise on behalf of the
organization to a person or a group of people.
Almost Never Occasionally Usually Always N/A
II. Relationships
Community
I promote community health status improvement as a guiding goal of my
organization and as a cornerstone of my efforts on behalf of my organization.
Almost Never Occasionally Usually Always N/A
I personally devote time to developing solutions to community health problems.
Almost Never Occasionally Usually Always N/A
I participate in and encourage my management team to devote personal time to
community service.
Almost Never Occasionally Usually Always N/A
Patients and Their Families
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 7/15
I use a patient- and family-centered approach to patient care.
Almost Never Occasionally Usually Always N/A
I am a patient advocate on both clinical and financial matters.
Almost Never Occasionally Usually Always N/A
I ensure equitable treatment of patients regardless of socio-economic group or
payor category.
Almost Never Occasionally Usually Always N/A
I respect the practices and customs of a diverse patient population while
maintaining the organization’s mission.
Almost Never Occasionally Usually Always N/A
I demonstrate through organizational policies and personal actions that
overtreatment and undertreatment of patients are unacceptable.
Almost Never Occasionally Usually Always N/A
I protect patients’ rights to autonomy, clinical efficacy, and full information about
their illnesses, treatment options, and related costs.
Almost Never Occasionally Usually Always N/A
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 8/15
I promote medical record confidentiality and do not tolerate breaches of this
confidentiality.
Almost Never Occasionally Usually Always N/A
Board
I have a routine system in place for board members to make full disclosure and
reveal potential conflicts of interest.
Almost Never Occasionally Usually Always N/A
I ensure that reports to the board, my own or others’, appropriately convey risks of
decisions or proposed projects.
Almost Never Occasionally Usually Always N/A
I work to keep the board focused on ethical issues of importance to the
organization, community and other stakeholders.
Almost Never Occasionally Usually Always N/A
I keep the board appropriately informed of patient safety and quality indicators.
Almost Never Occasionally Usually Always N/A
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 9/15
I promote board discussion of resource allocation issues, particularly those where
organizational and community interests may appear to be incompatible.
Almost Never Occasionally Usually Always N/A
I keep the board appropriately informed about issues of alleged financial
malfeasance, clinical malpractice and potential litigious situations involving
employees.
Almost Never Occasionally Usually Always N/A
Colleagues and Staff
I foster discussions about ethical concerns when they arise.
Almost Never Occasionally Usually Always N/A
I maintain confidences entrusted to me.
Almost Never Occasionally Usually Always N/A
I demonstrate through personal actions and organizational policies zero tolerance
for any form of staff harassment.
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 10/15
Almost Never Occasionally Usually Always N/A
I encourage discussions about and advocate for the implementation of the
organization’s code of ethics and value statements.
Almost Never Occasionally Usually Always N/A
I fulfill the promises I make.
Almost Never Occasionally Usually Always N/A
I am respectful of views different from mine.
Almost Never Occasionally Usually Always N/A
I am respectful of individuals who differ from me in ethnicity, gender, education or
job position.
Almost Never Occasionally Usually Always N/A
I convey negative news promptly and openly, not allowing employees or others to
be misled.
Almost Never Occasionally Usually Always N/A
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 11/15
I expect and hold staff accountable for adherence to our organization’s ethical
standards (e.g., performance reviews).
Almost Never Occasionally Usually Always N/A
I demonstrate that incompetent supervision is not tolerated and make timely
decisions regarding marginally performing managers.
Almost Never Occasionally Usually Always N/A
I ensure adherence to ethics-related policies and practices affecting patients and
staff.
Almost Never Occasionally Usually Always N/A
I am sensitive to employees who have ethical concerns and facilitate resolution of
these concerns.
Almost Never Occasionally Usually Always N/A
I encourage the use of organizational mechanisms (e.g., an ethics committee or
program) and other ethics resources to address ethical issues.
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 12/15
Almost Never Occasionally Usually Always N/A
I act quickly and decisively when employees are not treated fairly in their
relationships with other employees.
Almost Never Occasionally Usually Always N/A
I assign staff only to official duties and do not ask them to assist me with work on
behalf of my family, friends or associates.
Almost Never Occasionally Usually Always N/A
I hold all staff and clinical/business partners accountable for compliance with
professional standards, including ethical behavior.
Almost Never Occasionally Usually Always N/A
Clinicians
When problems arise with clinical care, I ensure that the problems receive prompt
attention and resolution by the responsible parties.
Almost Never Occasionally Usually Always N/A
I insist that my organization’s clinical practice guidelines are consistent with our
vision, mission, value statements and ethical standards of practice.
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 13/15
Almost Never Occasionally Usually Always N/A
When practice variations in care suggest quality of care is at stake, I encourage
timely actions that serve patients’ interests.
Almost Never Occasionally Usually Always N/A
I insist that participating clinicians and staff live up to the terms of managed care
contracts.
Almost Never Occasionally Usually Always N/A
I encourage clinicians to access ethics resources when ethical conflicts occur.
Almost Never Occasionally Usually Always N/A
I encourage resource allocation that is equitable, is based on clinical needs and
appropriately balances patient needs and organizational/clinical resources.
Almost Never Occasionally Usually Always N/A
I expeditiously and forthrightly deal with impaired clinicians and take necessary
action when I believe a clinician is not competent to perform his/her clinical duties.
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 14/15
Almost Never Occasionally Usually Always N/A
I expect and hold clinicians accountable for adhering to their professional and the
organization’s ethical practices.
Almost Never Occasionally Usually Always N/A
Buyers, Payors and Suppliers
I negotiate and expect my management team to negotiate in good faith.
Almost Never Occasionally Usually Always N/A
I am mindful of the importance of avoiding even the appearance of wrongdoing,
conflict of interest, or interference with free competition.
Almost Never Occasionally Usually Always N/A
I personally disclose and expect board members, staff members and clinicians to
disclose any possible conflicts of interests before pursuing or entering into
relationships with potential business partners.
Almost Never Occasionally Usually Always N/A
10/10/2014 Ethics Self-Assessment
http://www.ache.org/newclub/career/ethself.cfm#site-header 15/15
I promote familiarity and compliance with organizational policies governing
relationships with buyers, payors and suppliers.
Almost Never Occasionally Usually Always N/A
I set an example for others in my organization by not accepting personal gifts from
suppliers.
Almost Never Occasionally Usually Always N/A
After you’ve completed the self-assessment:
Now that you have finished the self-assessment, you will want to review your
responses, noting which questions you answered “usually,” “occasionally,” and
“almost never.” You may find that in some cases, an answer of “usually” is
satisfactory , but in other cases, such as when answering a question about
protecting staff's well-being, an answer of “usually” may raise an “ethical red flag.”
You will note that the instrument does not have a scoring mechanism; this is
intentional. We do not believe that ethical behavior can or should be quantified.
We are confident that you will uncover few red flags and that if you do, you will
willingly and appropriately address them. We also want you to consider your
professional society as an additional resource when you and your management
teams are confronted with difficult ethical dilemmas. You should find our regular
“Healthcare Management Ethics” column in Healthcare Executive magazine a
useful resource as well as ACHE’s Ethical Policy Statements. In addition, you may
wish to refer to the Ethics Bibliography, which we have compiled for your use.
Finally, you may want to consider attending our annual ethics seminar.
American College of Healthcare Executives Copyright © 2014
