Ethical competence and moral capital in public health administration: Good for what ails us

Public health administrators are attracted to the field by wanting to do “Good.” Soon, we find ourselves speaking more softly about our moral priorities, as political and fiscal “realities” are urged upon us. We decide to win what we can win, settle for less, and hope the worst is behind us. These lessons are only half right. As responsible stewards of precious public health assets, we must be practical and realistic, AND it is also the case that success for our efforts lies in wholeheartedly incorporating our morals into our organizational decision-making. Currently, we rely almost exclusively on rational and political models which we have internalized as the “best-chance bases” for our programs, on expediency-based models which “dis-courage” us from placing before stakeholders and constituencies the values agenda that underlie our joint efforts. Too often, we do not make plain the ethical bases for our practices and priorities. Drawing from the business literature on customer value propositions and on incorporating equity considerations in management of public health resources, this presentation offers a promising practical model for decision-making which can develop ethical competence and moral capital within our organizations. This approach balances the need for rationality in resource allocation, accountability and quality improvement with successful strategies for using our aspirational values to defend and advance public health programs. We enlarge our notion of what is “winnable”, and the output is an organization – and community - strengthened by frank consideration of how it puts its moral values into practice.