Does ethics have a role in recruitment

Contemporary recruitment procedures are carefully designed so as to avoid unlawful discrimination. This results in precisely crafted job criteria and scrupulously even-handed treatment of applicants. This careful attention to fairness could be said to express the ethical value and principle of justice and, accordingly, to this extent recruitment processes do provide a role for ethics.
There is, however, an opportunity for a broader and deeper consideration of the contribution that ethics could make to recruitment, particularly in health care organisations. This consideration finds evidence of ethical considerations not merely in procedure, as is the case with justice, but in the very criteria that are used to select applicants. A brief historical excursion is necessary to explain a view about healthcare organisations and ethics.
Healthcare organisations and ethics
The ethics of medical professional practice dates back to Hippocrates in the fourth century BC. Although these principles continued to be refined and published as professional codes of practice, other sentinel events in the last century took ethics to a broader level.
The first of these was the Nuremberg “doctors’ trial” in 1946 - the source of the Nuremberg code: an international statement of the ethical principles for research. A second was the revelation of the Tuskegee syphilis study – a 40 year study of the untreated progress of syphilis - that was followed, first in United States and later in other nations including Australia, by the establishment of an ethics review regime for research involving humans. A third was the publication of “Principles of Medical Ethics” by Tom Beachamp and James Childress in 1979.Drawing on the history of ethics in medicine, these authors formulated four principles of medical ethics – respect for autonomy, beneficence, non-maleficence and justice – which have become the touchstone of modern medical ethics.
A fourth was the broadcast by Ian Kennedy of the BBC’s Reith Lectures, since published as “The Unmasking of Medicine” in 1980.These lectures challenged the established authority of medicine and the very basis on which that authority had been traditionally asserted. Provocative and controversial, they generated heated reaction.
By the 1980s, ethics in healthcare had undergone a fundamental revision and a reassessment of conventional structures of authority and influence.
Enclaves of ethics
However, there followed a tendency to reduce these ethical principles to procedures: human research ethic committees for research and clinical ethics committees for clinical medical practice.
Institutions established these procedures as means of demonstrating conformity with the principles. A consequence was to confine the consideration of ethics to the enclaves in which these procedures operated. Ethics was addressed explicitly only in consideration of human research or in difficult clinical practice situations and came to be associated - and even equated - with procedures, applications and approvals. Individual professionals may have adopted a similar approach and explicitly considered ethics only when in one of these enclaves. ‘Getting’ ethics approval was the aim.
A response to the risk of these trends was a return to the ethical thinking of Aristotle.Known as virtue ethics, this response, notably by David Thomasma and Edmund Pellegrino, identified ethics in the habitual dispositions of individual professionals. These included trust, compassion, prudence, justice, fortitude, temperance, integrity, and self-effacement. Ethics is about the quality of individual conduct and not the propriety of procedures.
Ethics in healthcare institutions
If the ethics of physicians can or should be assessed by the quality of their conduct, could a similar assessment be applied to healthcare organisations? A challenge - or an invitation – could be: what are the ethical qualities by which this organisation wishes to be known and recognised? When members of the public seek treatment or care, will they know which organisation they are in by the ethical qualities they see in the conduct of the staff who attend to them: in the wards, at the admission counter and the payment office? Could evidence of some or all of these qualities be required of administrative or health professionals who seek employment?
These questions are perhaps speculative.Whether the requisite virtues can be identified and how they can be demonstrated in applicants are not simple questions. However, asking the questions accepts the possibi ity that ethics can have some role in recruitment.
Colin Thomson
BA, LLB, LLM (Sydney)
www.ehealthinfo.gov.au
Colin Thomson, BA, LLM (Sydney) is Professor of Law at the University of Wollongong and Academic Leader for Health Law and Ethics in the Graduate School of Medicine. He also works as a consultant.
He was a member of the Medical Research Ethics Committee (1988-91) of the National Health and Medical Research Council and, from 1998-2002 a member, and from 2006-2009, chair of the Australian Health Ethics Committee. As a consultant, he has advised NHMRC, FaHCSIA, Health Departments of NSW, Qld and Vic and several universities. He is a Senior Consultant with Australasian Human Research Ethics Consultancy Services (www.ahrecs.com).
Colin has provided training to human research ethics committees, chairs the CSIRO Social Science HREC and is a member of HRECs at Department of Health and Ageing and University of Wollongong/Illawarra Shoalhaven LHD.
He is a joint author of Good Medical Practice: professionalism, ethics and law, 2010, Cambridge University Press.
“Ethics is about the quality of individual conduct and not the propriety of procedures.”
Colin Thomson