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The Need for Institutional Checks on Mishandling Conflicts
Wednesday, October 16th, 2013
Robert Wechsler
Six years ago, I wrote a
blog post on apology (including full disclosure) in the
medical context. Today's
New York Times' "Invitation to a Dialogue" letter from a
hospital executive takes this issue a step further to a
consideration of the value of individual punishment vs.
institutional change. The lesson he provides is one that is important to government ethics, as well.
A patient woke from an operation to find that the wrong ankle has been operated on. The surgeon immediately reported the error, and offered an apology to the patient (and presumably operated on the correct ankle). The hospital realized that there were systemic problems in its preoperative procedures, and it spent several weeks strengthening its care delivery system to minimize the chance of a similar error in the future. The surgeon was not punished.
When a hospital trustee asked why he wasn't punished, the hospital executive said that the surgeon already feels terrible about the mistake, and that "further punishment does not act as a deterrent in these kind of inadvertent errors.”
I would have added that this is an institutional problem, not an individual problem. The same is true of many government ethics matters. If a government were to institute checks to minimize the chance of officials participating with a conflict, it would prevent many inadvertent errors. Such checks would also make ethics violations that did occur more likely to be intentional and, therefore, easier for ethics commissions to seriously punish.
Two checks are especially valuable. One is to ask, before consideration of every agenda item, whether any member or staff has a special relationship with anyone involved in the matter, providing the names of such individuals and companies, including those of their representatives. This prevents ignorance (or the ability to feign ignorance) from getting in the way of responsibly handling a conflict situation.
Another is to require that, when an official realizes that she has a special relationship with someone involved in a matter (especially outside of a meeting), that official disclose the possible conflict and either immediately withdraw from participation or immediately seek ethics advice. If the official does not do either, then there would be an ethics violation. If the official does one or the other, then she, the government, and the public are protected.
Few local governments have, or have even considered, such checks. They may not do surgery, but they can do great harm to the public trust by failing to do what they can to prevent unnecessary scandals.
Discussing such checks is also an acknowledgment that much of government ethics involves institutional problems rather than individual problems. This is an important lesson for governments and the public to learn. Punishment of individual ethics code violators is important, because in appropriate situations it does deter misconduct. But it is the most expensive, uncertain, damaging, and sometimes unfair form of deterrence. Prevention through training, advice, and institutional change is far more desirable.
Robert Wechsler
Director of Research-Retired, City Ethics
---
A patient woke from an operation to find that the wrong ankle has been operated on. The surgeon immediately reported the error, and offered an apology to the patient (and presumably operated on the correct ankle). The hospital realized that there were systemic problems in its preoperative procedures, and it spent several weeks strengthening its care delivery system to minimize the chance of a similar error in the future. The surgeon was not punished.
When a hospital trustee asked why he wasn't punished, the hospital executive said that the surgeon already feels terrible about the mistake, and that "further punishment does not act as a deterrent in these kind of inadvertent errors.”
I would have added that this is an institutional problem, not an individual problem. The same is true of many government ethics matters. If a government were to institute checks to minimize the chance of officials participating with a conflict, it would prevent many inadvertent errors. Such checks would also make ethics violations that did occur more likely to be intentional and, therefore, easier for ethics commissions to seriously punish.
Two checks are especially valuable. One is to ask, before consideration of every agenda item, whether any member or staff has a special relationship with anyone involved in the matter, providing the names of such individuals and companies, including those of their representatives. This prevents ignorance (or the ability to feign ignorance) from getting in the way of responsibly handling a conflict situation.
Another is to require that, when an official realizes that she has a special relationship with someone involved in a matter (especially outside of a meeting), that official disclose the possible conflict and either immediately withdraw from participation or immediately seek ethics advice. If the official does not do either, then there would be an ethics violation. If the official does one or the other, then she, the government, and the public are protected.
Few local governments have, or have even considered, such checks. They may not do surgery, but they can do great harm to the public trust by failing to do what they can to prevent unnecessary scandals.
Discussing such checks is also an acknowledgment that much of government ethics involves institutional problems rather than individual problems. This is an important lesson for governments and the public to learn. Punishment of individual ethics code violators is important, because in appropriate situations it does deter misconduct. But it is the most expensive, uncertain, damaging, and sometimes unfair form of deterrence. Prevention through training, advice, and institutional change is far more desirable.
Robert Wechsler
Director of Research-Retired, City Ethics
---
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