Ethics leadership in research, healthcare and organizational systems: commentary and critical reflections.

Author:Gabriele, Edward F.


In the last century, the dialogue between academic inquiry/scientific discovery and ethics has undergone unprecedented development. This development is completely understandable given the enduring questions and critical reflections that have arisen from a necessary tension between a consideration of what is possible for human beings to discover or invent, and how such discoveries and inventions may impact the good of individuals, societies, and cultures. This is a healthy and critical tension that has as its ultimate objective the preservation and advancement of "The Good" and even "The Best."

Yet the dialogue between discovery/invention and ethics has also developed and deepened because of real historical tragedies that arose from a lack of ethics education or awareness, an inability to engage in mature ethical discernment, or everpossible problems due to less-than-positive motivations. In response to such incidents, governments and societies have enacted diverse regulations and set up oversight bodies to ensure that "The Good" is always maintained. Such provisions have great importance in research of all disciplines, in healthcare and human services, and in organizational systems and their mission development.

Yet a casual observation of some sets of regulations--or of the activities of some various ethics leadership bodies, or boards or committees --makes one wonder: What is their strategic purpose? What is their understanding of "ethics" itself? What is their role in ethical leadership within their institution? What approaches have ethics leadership bodies evolved that may not be as helpful as others? What strategies might be envisioned that will help ethics leaders and committees to maintain their ultimate purpose in the most beneficial way'?

Given the essential and diverse roles of ethics leadership bodies in research, healthcare, and organizational systems, there is a need in this age to come to a richer understanding of the nature of ethics itself and of how ethics promotes the best of all values systems while seeking to prevent problems and errors. Upon this foundation, it is necessary for ethics leadership and ethics bodies to engage in critical self-reflection upon their own role, style, approach, and meaning within the scheme of an organization's life and culture. Ethics leaders in diverse ways call researchers, healthcare leaders, and professionals to the task of living up to the highest values. It is equally important, then, that ethics leaders and committees engage in that same activity for themselves and for the ongoing development of their service on behalf of others.

Ethics leadership in society has always been a constant and critically important factor for academic, professional, and personal life. This article will seek to promote and undergird the essential role of ethics leadership in research, in healthcare, and in organizational systems. To do so, it will be necessary to address the fundamental nature of ethics itself, its place in the human historical context, several areas where quality improvement and change are needed, and several strategies for future growth and development. Lastly, what will be posited briefly is a powerful metaphor by which ethics leaders or ethics boards can understand their ongoing and essential role in the communities they are privileged to serve.

Ethics: Its Nature, Its Domain

If one is to understand the critical and powerful role of ethics leaders and structures in research, healthcare and organizational systems, a grounded understanding of ethics itself is important. Yet how is ethics best understood? From the most casual observations of daily conversation, one would have to conclude that the term itself is used and understood in a wide variety of ways. Like all other terms in common vocabulary, the word ethics is connotative or, in linguistic terms, tensive. In other words, it is "many meaninged." It is a rich term but one, like others, that can easily slip into diverse usages that may or may not be helpful.

Over the course of centuries in Western scholarship, ethics has been associated with a wide number of related academic and professional disciplines: law, general philosophy, moral philosophy, regulatory compliance; and, in ecclesiastical domains, the disciplines of moral theology and canon law. The relationship between these domains or disciplines and that of ethics is understandable, reasonable, and appropriate. However, it is unfortunate that there has also grown up in common parlance a reductionist tendency to equate ethics with one or more of these disciplines. A prudent review of this tendency would reveal that a complete equation of ethics with, perhaps, moral theology or canon law or law itself does not fit with the understanding of the nature of ethics as it has evolved, at least in Western civilization. Areas such as public law or church law deal with statute and social parameters that reflect the common boundaries that citizens agree are needed to uphold a peaceful and reasonable society. Moral theology reflects the nature of what is "good" or "evil" based upon a particular system of religious beliefs. In these two instances, equating ethics with any of these disciplines would give rise to a diversity of perspectives that could not sustain broad human agreement. Therefore, this manuscript will assume that ethics itself is a larger umbrella underneath which all of the other disciplines can well be understood and appreciated. Yet besides these academic perspectives, how is the term "ethics" understood in daily usage?

Within common parlance. "ethics" is often used to signify compliance with various standards or with law. This is a very common approach and one that is completely understood. The goal of ethics in this perspective is to regulate behavior or customs or requirements. In many cases, it is an approach well suited to social or cultural clarity. It gives rise to codes of ethics and behavior that ensure that social or group expectations are met uniformly and without deviation. In addition to this perspective, cultures and societies also speak of a group's particular "ethic." An ethic in this second sense means an organized pattern or image that conveys a particular value or set of principles to which individuals are meant to conform their own identity. "Ethic" in this sense is also a familiar means for conveying the image of a nation's self-understanding within the family of cultures. In the United States, for example, Americans utilize the ethic of "hard work" or "fair play" as a way of expressing one's identity as a citizen. Ethic in this sense is a means of conveying an image, a perspective, a corporate self-understanding. Yet, is ethics only about either ethical compliance or an ethic-image? In both cases, the end result of these two perspectives is conformity toward achieving an already defined goal of the perfect or The Good. They also define "'good" versus "bad." Is this what classical thought describes as "ethics'?" Does ethics in the highest sense only mean compliance or the avoidance of evil? What of new ideas of what constitutes The Good? What perspective allows for a culture or nation or society to grow and develop and evolve?

Classical and contemporary academicians have posited that ethics is concerned ultimately with the character of persons and/or institutions. In fact, that is its origin in language, its primordial linguistic definition from the Greek ethos. Ethical formation is, then, a question of character development for individuals, groups, institutions, societies, and cultures. It is the foundation upon which individuals and societies can choose "The Good" freely and without undue coercion. It is not just about good versus evil. Rather, ethics is an emergent and evolving discovery of what constitutes "The Good." In fact, ethics is what allows for and assists explorations of sometimes competing "goods." From this perspective, ethics does not just look to the prevention of evil, but equally or more so to the promotion of The Good. It might then be posited that ethics in this regard is an academic and professional "'domain" under which all of the ethics-related disciplines discussed previously are gathered in a type of synergy. Therefore, if one were to explore the meaning and critically important contributions and services of ethics leaders and structures, it would be an enriching and illuminative experience to reflect upon how such leaders, committees, boards, or other bodies are as much about enriching and promoting the character of persons and institutions as they are about preventing non-compliance or failure to meet obligations and expectations. This raises the question of the context of ethics leadership and how this has developed over time and within the human condition.

Historical Phenomenology

Over the last century, historical circumstances have...

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