Ethics Education for Healthcare Administrators: Challenges and Opportunities for Thinking Differently about Health Care Ethics

Ethical issues abound in healthcare administration including conflicts of interest and commitment, fairness and transparency in personnel management and human resources, resource scarcity and budgeting, stakeholder management, reporting fraud and abuse, and administrative professionalism.

Historically, bioethics has been the field focused upon the dilemmas that occur in the context of clinical care and biomedical research. More recently, discourse in bioethics has expanded to include population health and empirical accounts of the ethical domain. Little explored or addressed in bioethics are the ethical issues faced by heath system leaders and administrators, particularly mid-level managers through c-level executives.  Countless healthcare administrators face ethical conflicts, moral obligations, and potential solutions to ethical problems are different from either those at the bedside or the bench or the realms of public health policy and government. Conventional topics and approaches to teaching bioethics do not prepare healthcare administrators, and by extension this population regularly registers frustration with outcroppings of ethical issues for which they are armed only with intuition, law and previous anecdotal experience. 

Based upon the experiences of teaching ethics in a health care administration program, we will present three different aspects of this issue: (1) an outline of the topics that arise as ethical issues for health care managers and administrators, differentiating these from traditional health care ethics, (2) an argument that these issues require taking a different approach to professional education in the entire healthcare executive echelon, and (3) a novel approach to inculcating healthcare management ethics based on teaching those organizational ethics, business ethics, medical professionalism and mainstream bioethics skills identified as missing in (2) above.