Jeffrey Saltzman's Blog

Enhancing Organizational Performance

First, Do No Harm

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The notion of “first, do no harm” arises from the world of medicine. While that exact phraseology is not part of the Hippocratic Oath the intent is certainly there.  From the original oath, “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.”  Late in the 1800’s medical professors began to use the phrase in writings and in their lectures to students. The notion was further refined to have health care providers “consider the possible harm that any intervention might do…and recognition that human acts with good intentions may have unwanted consequences.”

As an example of good intentions having unintended consequences, it has been reported that Libyan rebels who where supported first by the United States air bombing campaign, and then NATO, overran weapons depots of the Kaddafi government, selling the mustard and nerve gas shells they obtained from those depots to the terrorist organizations Hezbollah and Hamas, through Iranian channels and funding.  As the materiel was being transported through Sudan’s well known arms smuggling routes on its way to the Gaza Strip, the individuals responsible for the arms transfer mysteriously had their car hit by  a missile.  The good intentions of supporting the overthrow of a dictator, resulting in the unintended consequences of putting extremely lethal mustard and nerve gas into the hands of those who would not hesitate to use them on civilian population centers. Protecting civilian population centers as an ethical standard seems to apply to the Libyan rebels only when those population centers are theirs.

First, do no harm, and its implication of perfect knowledge, when taken to the extreme of unintended cause and effect has the potential of resulting in greater harm through paralysis and inaction. What are the longer term consequences, if for instance I was running a company that had expenses that were greater than income, and I chose to do nothing about it? I freeze because the consequences of the potential actions (e.g. forcing early retirements, layoffs, freezing or reducing salaries, forced part-time, cutting benefits, eliminating expenses) will result in harm to a subset of individuals, the harm however, will be greater in terms of the number of people affected when the company subsequently fails.

What if a rapidly spreading disease kills 50% of those afflicted, and I choose not to distribute a vaccine that will save the lives of 50 out of 100 afflicted people, but will result in the deaths due to allergic reactions of 5% who otherwise might survive, am I guilty of greater or lesser harm? By distributing the vaccine I can save a substantial number of lives, but by acting I will knowingly kill people, but not as many as would otherwise perish. Most choices are not easy and often have unintended consequences. But what about when people act, not taking the unintended into account at all?

Contrasting the role of behavioral expectations in the roles of medicine vs. business, Jonathan Baron of the University of Pennsylvania writes, “the positive obligations that stem from ethical codes are almost always contingent on voluntary promises and agreements. Likewise in business, almost all positive obligations arise from contracts, even if the contracts are only implicit.” His point of view would conclude that the obligations that arise from an ethical moral code are voluntary, while those that arise from business are legislated through a contract. Therefore, using this logic, obligations that arise in business cannot be assumed to be executed in an ethical manner unless they are contractual and/or by extension regulatory.

The number of and types of scandals that have been evident in American business recently seems to support this notion. In the Forbes Corporate Scandal Sheet they actually state that “ we’ll follow accounting imbroglios only–avoiding insider-trading allegations like those plaguing ImClone, since chronicling every corporate transgression would be impractical–and our timeline starts with the Enron debacle.” It then goes on to list scandals that hit 21 major companies from 2002 alone. It is easy to be cynical about ethics in corporate America when you could pick up the Wall Street Journal from virtually any day and read about some ethical scandal or another.

What are the obligations of those working for or supporting organizations that are involved in unethical or immoral practices? Should workers follow some sort of code of conduct, an oath to uphold business ethics that they take upon being hired by a company? And maybe once a year they renew their vows? Should workers be able to point to an outside moral code of conduct when an organizational leader asks them to do something that crosses the line? How could a company object?

In one study Dan Ariely, MIT professor and author of Predictably Irrational found lower levels of cheating on a test when the participants were reminded of a moral code just prior to the test.  Organizations cannot actually be unethical or immoral, only people can. People are the only ones who can behave ethically or unethically and it is people who direct organizations. That is why organizations are very rarely charged with a crime, but people within organizations can be. Organizations tend to be charged only when the illegal behavior has been systematized across the institution.

The challenge will be in the definition of ethics itself. And with some of the miscommunication/varying definitions that stem from incongruous meanings of the term ethics, depending on where you sit in the organization. For a typical worker, ethics often revolves around relationships, trust, being true to your  word. If the management of an organization changes the workers benefits, work schedules, overtime requirements, staffing or workloads, the management runs the risk of being seen as in violation of voluntary promises and agreements which can be deemed as unethical. Meanwhile those in management can look at those same changes and deem them as lawful and not in violation of any contract and therefore see no ethical issue. Managements see ethics as  related more to following the legal letter of the law and based on this standard of ethics, if there is a legal way to break a contract that would be ethical  ehavior, as would be a legal way to reduce headcount etc.  Ethics is a word that holds somewhat different definitions depending on whom you are asking to define it.

But if we as a nation can derive a universal standard of business conduct, say the 15 Commandments of Business Ethics, no lets shorten it to 10 (thank you Mel Brooks), and have every worker (management as well as non-management) subscribe to those standards we may make a positive impact on what we  view as ethical behavior.

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Ariely, D. (2009) Our Buggy Moral Code, TED Talks, http://www.ted.com/talks/dan_ariely_on_our_buggy_moral_code.html

Baron, J. (1996). Do no harm. In D.M.. Messick & A.E. Tenbrunsel, Codes of conduct: Behavioral research into business ethics. pp.  197-213. New York: Russell Sage Foundation.

Debka, (04/07/2011) Special operations team hit top Iranian-Hamas arms smugglers in Sudan, http://www.debka.com/article/20821/

Forbes.com, The Corporate Scandal Sheet, (08/06/2002) http://www.forbes.com/2002/07/25/accountingtracker.html

Hippocratic Oath (4/17/2011) http://en.wikipedia.org/wiki/Hippocratic_Oath.

Jolton, J. & Saltzman, J. 2008, Preventative Maintenance: How Industrial/Organizational Psychologists Can Build and Maintain  an Ethical Culture, SIOP annual convention.

© 2011 by Jeffrey M. Saltzman. All rights reserved.

Visit OV: www.orgvitality.com

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