EMS Revisited: The Value of Ethical Behavior

This article originally appeared in the January 2003 issue of EMS World Magazine. Gary Ludwig is a featured speaker at the 2012 EMS World Expo, scheduled for October 29–November 2 in New Orleans, LA. For more information, visit EMSWorldExpo.com.

There you are, sitting in your office one day, enjoying the fruits of your hard work and labor. As an EMS manager, you run a first-class delivery system. You find yourself looking over last month’s statistics, and everything looks good. Response times are below required standards, your budget numbers are excellent and morale is decent, except for a small number of malcontents. The Board of Directors is happy with your performance.

Then your world comes crashing down as your secretary informs you there’s an investigative reporter from the local newspaper in the lobby wanting to speak to you. Your mind races as you walk out to greet him, but you conclude that he must be working on a story in which one of your EMS crews responded and transported a patient. As you lead the reporter back to your office, making small talk, you come to realize he is not that congenial.

Settling down in your office, you find out the purpose for his visit: He asks you why you had some automobile body work done on your wife’s car at the same repair shop that works on your ambulances. Your wife’s car recently had some significant damage to the fender repaired at this shop, and they only charged you $20. You even wrote them a check.

The reporter has done his homework. He has a copy of the work order from the repair shop, and it shows eight hours of work from the repair people. You look at it but have no knowledge of it, since the owner of the repair shop only gave you the final bill of $20. You plead your case with the reporter, but it is obvious he already has the story written and is looking only for your comments. You don’t know what’s wrong with this picture. You paid for the services; you didn’t get anything free. What’s the problem?

Breaking the Code
The obvious problem is a conflict of interest. You did personal business with someone with whom you also have a business relationship. After all, who can have automobile body work done for $20? Either the body-shop owner cost-shifted your bill to work done on one of your ambulances, or he gave you a low price to steer more business back his way. No matter the reason, the entire deal smacks of impropriety. Unfortunately, the story makes front-page news in your community, and now an internal investigation is underway. There’s a cloud hanging over your reputation and character.

An Ethical Code
You have violated a code of ethics. Ethics can be appropriately defined as standards or principles that govern the behavior of an individual or a group. Sometimes, managers are asked to sign a code of ethics that spells out such things as conflicts of interest, financial disclosures or actions you must take after employment with a company or government agency. Many post-employment actions include not working for a competitor within a certain period of time, taking customers with you when you leave or disclosing the financial health of a private company.

The core values that dictate a person’s ethics come from many sources. Such things as experience, science, culture and religion influence our moral attitudes. Other factors that shape our ethical behavior include professional oaths, codes or laws.

As an EMS manager, you will be constantly challenged with situations you must evaluate and, based upon your core values, make a decision. Some managers take the path of “do no further harm.” In essence, whatever your decision, first ask yourself, will my decision cause harm to the citizens (customers), my organization, my employees or myself? If there is the possibility of causing harm, the decision becomes easy: Just don’t do it. Others ask themselves, am I questioning my actions? Do my decisions not feel right? As I like to say, “If it doesn’t pass the smell test, it must be wrong.”

Maintaining Integrity
The value of ethical behavior should saturate all levels of EMS agencies. Not only should managers and supervisory personnel be held to ethical behavior, but so should the street medic. EMS managers and supervisors should not excuse unethical behavior by subordinates. After all, those same managers and supervisors are responsible for actions taken under their authority.

Managers and supervisors sometimes find themselves in ethical quandaries when they socialize with other members of their organizations. I remember one occasion when a chief went to a Super Bowl party and saw an employee there who had called in sick that day. Obviously, what the employee did was unethical, since he wasn’t truly sick, but should the chief dock him for abusing sick leave, or ignore what he saw? The situation posed an ethical dilemma for the chief.

Newspaper and television stories constantly report unethical behavior by and scandals involving public officials. Unfortunately, these stories, whether or not they have merit, can ruin an official’s reputation and end his or her career. Only with proper application of ethical standards can an EMS manager or supervisor maintain the integrity of themselves and their organization.

Gary Ludwig, MS, EMT-P, is a deputy fire chief with the Memphis (TN) Fire Department and chair of the EMS Section for the International Association of Fire Chiefs (IAFC).