Ethics in Business: Rights Based Approach

Analysis of common ethical issues

Fa ci l i ta ted by: Soha i l uddi n Al a vi , Cours e Di rector Contri buted by cours e pa rti ci pa nts of Ethi cs a nd La w, Cl a s s 2013, Ins ti tute of Hea l th Ma na gement, Dow Uni vers i ty of Hea th Sci ences , Pa ki s ta n

Introduction: This document summarizes class discussions and analyses of common ethical issues facing the professionals with particular reference to Medical Service Providers. The selected analyses contained in this document are general topics followed by more specific topics relating to medical practices. The analysis is based on the rights based paradigm. Furthermore, these analyses are not judgmental but descriptive in their scope. 1. Analysis of Implicit Dilemmas a. (It is the universally accepted p ractice that investor the risk taker takes the extra large portion of business profits compared to the employees who invest their time, knowledge, energy and efforts for a fixed salary). Perspective: The above situation refers to an ethical dilemma of capital provider vs. employees who invest their imagination, skills, and time. A successful business venture essentially entails a feasible business idea, imagination to avail of market opportunities and resolve problems, diverse skills-set, time commitment, and last but not the least adequate capital resources. Having said this, the stakeholders relationship is reciprocal or inter dependent. Hence, it would be nave to consider any single stakeholder as the important factor, rather both are mutually complementing to each other. Furthermore, in case of profitable business operations the position of investor of capital resources is better off than the employee. Why? Because the investors initial capital remains intact in business hence the return is in real terms over and above the investment. On the contrary, the employees position is somewhat weaker because his or her investments perish away over time irrespective of profitable operations. However, the compensation to employees is generally reflective of just compensation of their investment alone and they get no share in the profits. So long the employees are assured compensation for their efforts alone it is ethical that they earn no share in the profit for they shall not be liable to bear the loss either. However, if the compensation policy is somehow linked with business results then it becomes imperative that the employees earn equitable share in the profits over and above their basic compensation and their basic compensation is equitably adjusted for losses as well. Analysis: The universally accepted practice that permits the capital provider chunk of profit is ethical so long employees are compensated for their imagination, skills and time as fairly as possible. However, if the employees are expected to take responsibility for profits then the contract should be that employer

Ema i l your comments / feedback to ccgroup.pakistan@gmail.com

Ethics in Business: Rights Based Approach

Analysis of common ethical issues
Fa ci l i ta ted by: Soha i l uddi n Al a vi , Cours e Di rector Contri buted by cours e pa rti ci pa nts of Ethi cs a nd La w, Cl a s s 2013, Ins ti tute of Hea l th Ma na gement, Dow Uni vers i ty of Hea th Sci ences , Pa ki s ta n

share profit with them in a fair manner over and above their compensation and that they will share losses with the employer by way of reduced compensation. b. (There was this person who has been a bright student always. From the beginning of his academic career he had flair to become doctor of medicine. He got admi ssion in the Medical College on merit alone and completed the required curriculum with good grades. He then had scholarship from overseas to specialize in the field of Cancer. He was all set to practice as a Cancer specialist, providing hope to thousands of people suffering from this deadly disease. When he returned home after completing his specialization he had chosen to manage his family business. Today by the Grace of Allah the company has expanded its business many times, which is a reflection of good business acumen of this professional medical Doctor) Perspective: The above situation refers to an ethical dilemma of individual vs. individual himself and the society. Hence it needs to be analyzed from two dimensions: individuals own right and the right of society. The relationship of an individual with the society also referred to as social contract, can be described into three broad levels namely; dependent, independent and interdependent. In a typical (Dependent relationship) the individual benefits from the society but does not reciprocate. Meaning either s/he is not in a position to or not willing to return back to the society for the benefits s/he has earlier received from it. The second manifestation is referred to as (Independent relationship). Here the individual does not feel dependent on the society for conducting his or her life and career hence the question of reciprocity does not arise at all. Third and last manifestation is referred to as (Interdependent relationship). In this case the individual is much cognizant and realistic of his or her reciprocal relationship with the society. Put it simply, the individual remains committed to reciprocate to the society for all benefits he earlier availed from the society. Analysis: The subject has chosen to purse his family business vs. practicing medical profession. The question is whether he has made the ethical choice? One can say that while choosing to manage business he might jeopardize his career in the long run as he has no formal training in business. This leads to asking another question: does he have the right to risk his career by choosing a profession he is not trained in, especially when he has opportunities for stable career in his own field of training. Individuals may differ, however, on the surface of it the answer is a big NO. It is quite obvious that he owes to the society for his education and training both in terms of the societys resources utilized in his education and training and opportunities sacrificed by other members of the society. Having said this, the only ethical way to reciprocate to the society is to practice his medical profession providing treatment and cure to the ailing members of the society. Teaching and
Ema i l your comments / feedback to ccgroup.pakistan@gmail.com

Ethics in Business: Rights Based Approach

Analysis of common ethical issues
Fa ci l i ta ted by: Soha i l uddi n Al a vi , Cours e Di rector Contri buted by cours e pa rti ci pa nts of Ethi cs a nd La w, Cl a s s 2013, Ins ti tute of Hea l th Ma na gement, Dow Uni vers i ty of Hea th Sci ences , Pa ki s ta n

training others in the profession will be walking an extra mile. On the contrary by choosing to run his business he is acting more of an independent person, which is unethical per se in his given situation. c. (Pharmaceutical industries are similar to any other industry. Likewise, the competition amongst the companies in the industry is no different from any fast moving consumer products company. Survival of any particular company is much dependent on the success of its branding and market penetration strategies, which help the company to enhance its products yield (cost to price ratio) and volume) . Perspective: The above situation refers to an embedded ethical dilemma of a business vs. society rights on each other. Businesses create multiple values in a society: goods and services (value for customers); employment (value for the society); opportunities for feasible investment (value for owners); etc. A complementary relationship between these values creates win-win scenarios where everyone comes out as a winner. On the contrary, competing relationship between these values lead to win -lose scenarios where everyone struggles to win over the other. For example, the seller tries to maximize his yield by maximizing the price and reducing product quantity and quality. Buyers use their bargaining power to pay less. And the employees do less work or bargain higher salaries for similar work leveraging their unique bargaining positions. In short, everyone effectively exploits their position advantage to gain over others. In Japanese culture there is this pro-verb KITA which means if you exploit your opponent today, your opponent will exploit you tomorrow. Analysis: Pharmaceutical businesses have right to recover their investments and secure higher but fair return on their investment, especially as they invest huge amount in the form of research and developm ent. However, they do not have the right to pursue their rights by violating customers or employees rights. Meaning to say, while perusing strategies to recover their investments and to secure higher returns they cannot choose to charge prices beyond the value-for-money and exploit employees weak position by paying less compensation to them. For instance, deceptive branding, persuading doctors unfairly and other mal practices would allow the business to improve its products and services yield but would d eter the value for money for the customers.

Ema i l your comments / feedback to ccgroup.pakistan@gmail.com

Ethics in Business: Rights Based Approach

Analysis of common ethical issues
Fa ci l i ta ted by: Soha i l uddi n Al a vi , Cours e Di rector Contri buted by cours e pa rti ci pa nts of Ethi cs a nd La w, Cl a s s 2013, Ins ti tute of Hea l th Ma na gement, Dow Uni vers i ty of Hea th Sci ences , Pa ki s ta n

2. Analysis of Ethical Behaviors and Norms a. (Ridiculing friends and foes) Analysis: In the above situation the explicit behavior of Ridiculing Friends and Foes manifests violation of multiple rights of the subject, namely; Ignorance of self respect and esteem, apathy for feelings, and distortion of public image. On the other side, such a behavior makes the person ridiculing the other vulnerable to similar behavior by the subject in return, thus he or she b esides violating subjects rights also violate his or her own rights. Norm: To get respect, one has to respect others! b. ( Selling blood or organs to save lives) Analysis In the above situation explicit behavior of Selling blood or organs to save lives involves rights of the person giving the blood or organ in consideration of money and the recipients. Let us examine the violation of ones own right in the given situation : It is likely that when money consideration is introduced it will induce the person to give blood more and more frequently or even sell his organ to fetch good price ignoring (or increasing) the risk to his own life. Now analyzing it from the recipients angle, securing a life should not be decision of affordability but it is every ones right. When blood and organs are given for money consideration it is likely it would lead to commercialization, which would in turn create Haves and Have -nots. Those who have enough money can afford to save lives while have-nots can not. Meaning, their right to save lives is replaced with their affordability. Furthermore, commercialization blood donation and organ donation is likely to create secondary market in which poor people would consider this as a viable business to earn their livelihood, but at what cost and for how long? Even sadly, it is much likely that brokers with access to a large poor population may also jump in this market to make money by exploiting the poor. Norm: The society must provide basic rights to all without bias and consideration!

Ema i l your comments / feedback to ccgroup.pakistan@gmail.com

Ethics in Business: Rights Based Approach

Analysis of common ethical issues
Fa ci l i ta ted by: Soha i l uddi n Al a vi , Cours e Di rector Contri buted by cours e pa rti ci pa nts of Ethi cs a nd La w, Cl a s s 2013, Ins ti tute of Hea l th Ma na gement, Dow Uni vers i ty of Hea th Sci ences , Pa ki s ta n

c. ( Conducting medical procedures when the patient is almost dead ) Analysis: Indeed it is patients right to be treated till the end and the doctors efforts are justified in doing so as his or her professional responsibility and commitment. Norm: All treatment possibilities shall be tried responsibly, until the patient is expired! d. ( Over-the-Counter sale of medicines ) Analysis: Customers insisting for p rescription-drugs over-the-co9unter are likely to jeopardize their health and life span. Sellers (Pharmacists) promoting or encouraging over-the-counter sale of prescription -drugs are likely to expose patients to high risk and foster unhealthy culture. Norm: Always adhere to OTC-standards in all conditions regardless of patients convenience or sellers own interest! e. ( Demonstrating apathy with the family of deceased patients) Analysis: A near to death patient expires and the Doctor who was attempting to review him/her walks out of the situation considering no need to give details to or sympathize with the patients family, is likely to secure his/her emotional consonance but would fail to discharge his professional responsibility to the patients family. Norm: Transparency of diagnosis and treatment is a must, and Must empathize with but do not duplicate feelings of the patients and/or their families! f. ( A 60 years old patient found to have a RTA (Road Traffic Accident) received in ER, while other patient aged 25 years was simultaneously received in the ER in similar condition. Only one bed was available at the time hence one patient could be treated )

Analysis: Treating the aged patient is likely to violate younger patients right to s urvive and vice versa. Hence the doctor preferring one over the other is likely to violate his/her responsibility. Norm: Commitment to treat everyone, regardless of the limitations and assumptions!

Ema i l your comments / feedback to ccgroup.pakistan@gmail.com