Administration and Leadership, Patient Care

Integrity & Ethics: Standing up for yourself & your organization

Issue 2 and Volume 34.

All through his years as president, Abraham Lincoln was under constant scrutiny, especially during the Civil War. And although he knew he would make mistakes while serving as president, he was determined to never compromise his integrity.

So deep-seated was his resolve, he once said, “I desire so to conduct the affairs of this administration that if at the end … I have lost every other friend on earth, I shall at least have one friend left, and that friend shall be down inside of me.”

We should each be this dedicated to our organizations, and this respectable. Because when there’s doubt about your integrity, not only do your personnel lose faith, but those outside, including citizens and other EMS agencies, will have little confidence in your organization.

Take the recent case of a paramedic supervisor in Colorado who allegedly forged his own paramedic license after he let it lapse. Instead of taking the appropriate steps to recertify, he doctored up someone else’s certification by putting his own name on it and presented it to his bosses as proof that he was recertified.

He then continued to work for another six months before a regular state audit of the licenses revealed the forgery. The first mistake was letting his license lapse.

The second, bigger mistake was faking his credentials and passing himself off as a licensed medical provider. The most troubling part is that he wasn’t the first to do this, and he certainly won’t be the last.

Unfortunately, plenty of headlines each year cast public safety professionals in a negative light. Some recent stories involve embezzlement, sexual assault and child pornography.

Keep in mind that many of these cases are only allegations, and the charges are likely just as common in any profession because they are based on human faults and bad decisions. The lesson for EMS leaders, however, is to stay out of the headlines and avoid damaging the public image of our profession.

What Is ‘Integrity’?

The Merriam-Webster dictionary defines “integrity” as a “firm adherence to a code of especially moral or artistic values.”

That code is your personal ethics, a set of standards or principles that govern your behavior. Being true to that code is basically the soundness of our moral character and how honest we are. But what may be completely unethical to one person might be perfectly all right with another.

For instance, as the head of your EMS organization, it might be OK for a sales representative from a monitor/defibrillator manufacturer to take you out to dinner and a ball game, while he tries to convince you to make a big purchase.

You might not see a problem with this activity, especially if your organization doesn’t prohibit it. A neighboring EMS organization, however, may have specific rules barring this type of marketing by sales people, or their system leader may simply have a personal ban against it without official rules. So, our ethics and integrity are subjective, but they’re not random.

Guiding principles—from experience, science, culture and religion—determine how we form our ethical beliefs. Also, any professional oaths we may have taken or signed and any laws or rules governing our organizations should be factored in.

For example, you may have signed a professional oath that you won’t accept monetary gifts or in-kind services from any company you do business with or may do business with. If you signed this type of professional oath, going to dinner and a ball game with the sales rep would be forbidden.

Even if you didn’t sign a professional oath, the Hippocratic oath for physicians could apply to our role as managers as well: “Do no harm.” Just as we follow this principle in medical practice to avoid injury to our patients, we should remember to protect our organization and our personnel.

Why Does It Matter?

Sometimes, our convictions and loyalties drive us to make decisions we think are defendable. This tendency is especially true when we have to make a decision concerning an employee with whom we’ve developed a friendship through years of working together. But, again, you have to ask yourself, “Can I defend my decision on the front page of the newspaper or to a TV reporter?” The bottom line is that if you’re truthful to yourself, you’ll be truthful to your organization.