From Values to Action: In Pursuit of Personal, Professional and Organizational Integrity



Edmonton, Westin Hotel, May 24, 2002

Agenda

9:00  Dramatization: Vignette #1
9:10 Table Talk
9:25 Introduction & Plenary Session 1:
The Case for Integrity: Living Our Values?
Arthur Schafer
10:05 Vignette #2
10:15 Plenary Session 2:
Integrity in One’s Professional Capacity
Laurie Zoloth
10:50 Break
11:20 Vignette #3
11:30 Plenary Session 3:
Integrity in Organizations
Laura Shanner
12:00 Questions from the floor
12:30 Lunch & Annual General Meeting
2:00 Concurrent Sessions (see below for details)
     
  • How Do We Strengthen Integrity When Things Go Wrong? Narrative and Ecological Approaches
    Gary Goldsand & Patricia Marck
  • Making Policy with Integrity
    Laura Shanner
  • Personal Choices in a Conflict of Interest
    Michael Burgess
  • Conflicts of Interest: An Organizational Perspective (Tentative)
    Arthur Schafer
  • Professional Integrity (Tentative)
    Laurie Zoloth
3:30 Break
4:00 Vignette #4
4:10 Plenary Session 4:
Moving to Action
Michael Burgess
4:40 Questions
5:00 Adjourn
   

Concurrent Session Abstracts

How Do We Strengthen Integrity When Things Go Wrong? Narrative and Ecological Approaches

Gary Goldsand & Patricia Marck
Ecology
n 1: the environment as it relates to living organisms; 2: the branch of biology concerned with the relations between organisms and their environment [synonyms: bionomics, environmental science]
Source: WordNet ® 1.6, © 1997 Princeton University

Narrative
“I can only answer the question, ‘What am I to do?’ if I can answer the prior question, ‘Of what story or stories do I find myself a part?’” (A. MacIntyre, 1981)

As a part of the ongoing exploration of different approaches to ethics, in this session we discuss the significance of “narrative” and “ecological” thinking in clinical ethics. We apply selected theories about ecosystems, health systems, and narrative ethics to develop an “ecological account” of a tragic and preventable adverse event: the death of an infant from a misread decimal point.

Adverse events inevitably test the integrity of professionals and institutions. They create unique challenges for hospital ethicists and clinicians involved in their aftermath. Our case discussion uses concepts of ecology and narrative to examine how integrity can be upheld and/or restored in the wake of adverse events. What is the role of a clinical ethics service in such situations? What are some of the methods we can use to ensure that any error in the clinical setting becomes an occasion for learning, reflection, future prevention, and integrity-building?

Narrative concepts like setting, plot, and character can be useful intellectual tools in ethical deliberation, and ecological signposts such as fragmentation, thresholds, and resilience can assist in our understanding of behavior in complex systems. Addressing this case together aims to provide participants with a means of reflecting on difficult cases in a particular way, and exemplifies the multi-disciplinary nature of ethical inquiry.

Making Policy with Integrity

Laura Shanner
Policy makers –in governments, in institutions, or in professional bodies – make decisions that apply across whole groups, rather than resolving individual ethical dilemmas as they arise. Policymakers also often establish rules that will apply to other people, but not to their own situations. Accordingly, they shoulder the responsibility common to all fiduciary relationships, which entail trust between persons with power and those who must rely upon them. We will explore ethical concepts such as openness, transparency, accountability, honesty, and commitment to common goods as possible foundations for ethical policy making. Conflicting needs, exceptions to general patterns, and finding common ground amid genuine disagreement challenge those who strive to balance personal integrity, necessary compromise, and practicality in the policy context.

Personal Choices in a Conflict of Interest

Michael Burgess
How do I recognize conflicts of interest and act with integrity? Participants will consider personal and sample cases in which a conflict of interest may exist, and how integrity and other considerations might guide appropriate action. Personal and professional choices often require that we balance interests that cannot all be maximized, so we will consider when these are conflicts of interest, and assess the appropriate degree of disclosure or distance from personal interests integrity requires. The session will develop practical understanding of how to identify conflicts of interest and develop a practical approach to how to manage conflicts of interest with integrity. We will also consider how to assess your intuitions related to integrity and whether it is ever appropriate to decide not to act on them.

Individual vs. Institutional Integrity: Paying a Heavy Price

Arthur Schafer
The scandal at The Hospital for Sick Children in Toronto which has come to be known as the Olivieri affair, and the more recent scandal at the Centre for Addiction and Mental Health, (The Healy Affair) raise important questions of both individual and institutional integrity. Both involved institutional conflicts of interest and in both the researchers
who stood up for the safety of their patients and for research integrity paid a heavy price. This session will explore the lessons of Olivieri and Healy for health care institutions and for every professional involved in the health care system.

Professional Integrity 

Laurie Zoloth