CMSA Today - Issue 2, 2011 - (Page 43)

CMSA Ethics Casebook We’re All Ethical Aren’t We? JOHN BANJA, PhD I t’s a pleasure to be invited by the editors of CMSA Today to launch this column on ethics in case management. I hope that this one, and future columns, will provide case managers and their organizations with some practical ideas that they can incorporate into their case management practices. It’s worth pointing out, especially in this inaugural column, that virtually everyone believes he or she is ethical or moral. In the 30 years I’ve been giving talks at hospitals and to professional organizations, never once has someone come up to me and said, “Ethics? Not us. We have no ethics. In fact, we believe that ethics interferes with our corporate mission, which is to do whatever it takes to make as much money as possible.” Such an admission would be unthinkable because human beings have a considerable, if not enormous, psychological inclination to preserve their self-esteem. But a key component of self-esteem is understanding oneself as a decent, honest, trustworthy, and reliable person. Consequently, we’d probably find it downright scary to be around someone who frankly admits to being unethical, not to mention that we’d have a very hard time trusting such a person, or his or her organization. Yet, our self-described unethical individual has said something interesting, because towing the ethical line can often be psychologically difficult and resource-intensive. Doing the right thing – like breaking bad news to a client or speaking up when the case manager sees a colleague practicing in a worrisome fashion – can be very uncomfortable and can even expose the case manager to harm (as in, “No good deed goes unpunished”). Of course, ethical guidelines for case managers exist, and it is the mark of the mature (or maturing) organization to develop them. Thus, case managers might go to Chapter 27 of the CMSA Core Curriculum for Case Management (edited by Suzanne Powell and Hussein Tahan) for some ethical insights. Or they might access the Code of Professional Conduct for case managers that was developed by the Commission for Case Manager Certification. However, even though these materials give a very good description of the ethical “personality” of the case manager, they simply can’t address the “in-the-trenches” ethical dilemmas that case managers routinely confront because no code of ethics or list of standards can anticipate how thick with details real-life cases are. This suggests something – perhaps we might call it Lesson #1 of these columns – that case management organizations must take to heart: If we want ethical case managers, then we need ethical case management organizations and leaders. Case managers, like virtually all professionals, will take many of their ethical cues from the people around them, and especially from their leaders. Consequently, if a case manager works in an environment where ethics is not taken seriously or, more likely, where employees are ethically “casual” or uncomprehending, there’s a very good chance that he or she will internalize those practices and attitudes. In future columns, I’ll explore some of these ideas in greater depth. For now, though, I’ll leave you with the suggestion that ethically problematic behavior often reflects an ethically lax organization whose leadership gives ethics short shrift. A fundamental need, then, is for what I’ll call “corporate ethical vigilance.” More to follow. ■ About the Author John Banja , PhD, is a professor of rehabilitation medicine and a medical ethicist at Emory University in Atlanta. He sat on the Commission for Case Manager Certification for six years and speaks frequently at case management conferences. He can be reached at Issue 2 • 2011 CMSA TODAY 43

Table of Contents for the Digital Edition of CMSA Today - Issue 2, 2011

CMSA Today - Issue 2, 2011
Table of Contents
Outgoing President’s Letter
Incoming President’s Letter
How Care Coordination Affects You
Demonstrating Case Management’s Value to Hospitals’ Bottom Line
Making the Case for Evidence-Based Case Management Practice and Programs
Association News
Ask the Expert
Facility Profile
View From Capitol Hill
Case Management and the Law
Ethics Casebook
Mentoring Matters
Index of Advertisers

CMSA Today - Issue 2, 2011