The diagram on page 4 of the Reader (see below) shows 'the ripple of effects from the personal right through both professional and organisational towards the society at large.' (Reader 5, p3)
Adapted from Reader 5 Professional Ethics
This diagram suggests that even the smallest of personal or professional ethical decisions can have a knock-on effect for the society at large and that professional and organisational codes of conduct or ethical practices can effect the individual practitioner as well as the wider world.
In the Reader it asks where the limits of responsibility lie, and from reading further and reflecting on what I've read I can begin to see that there are overlaps, with each context having the ability to affect others both in positive and negative ways.
In the first case study about the inquiry into standards of care at Stafford Hospital, this ripple effect is clearly seen working in two directions - both outwards (from personal to organisational) and inwards (from organisation to the individual) to create a dire set of consequences for patients at the hospital.
My immediate thoughts and notes, on reading the excerpt on page 5 (from The Guardian newspaper, 8th November 2010), were as follows:
- Failings were seen at every level of ethical principles. From the individual practitioners through the hospital managers to the authorities and agencies in charge of monitoring.
- Too many people 'in charge' with no-one actually keeping a strict eye on what was actually going on.
- No-one wanting to accept responsibility for events for fear of losing jobs, not achieving targets, losing funding, etc.
- Those who did raise concerns were ignored or made to feel like troublemakers.
- Those at grass roots level stuck in a position of hopelessness due to insufficient support and staffing.
- Hospitals now run as businesses not to provide a service, and the shift from people to figures has lead to less importance being placed on health care and instead being all about balancing budgets.
This upward spiral of events does seem somewhat idealistic though...
How much influence can staff at grass roots level have on influencing the decisions of upper management? How can hospital management provide funding for better services when they have already been asked to make more cuts by their governing bodies?
I then went on to read some of the findings of the inquiry undertaken by Robert Francis QC, http://www.midstaffsinquiry.com/pressrelease.html, which confirmed some of my initial thoughts and opened up some new areas of thinking. However, what I found most shocking was my lack of surprise at what I was reading. Not that I didn't find it appalling or upsetting but that I was certainly not surprised at the things that had happened. Did anyone else feel like that?
With this in mind, my final thought for this blog is in the form of a question,
Has the ripple effect lead to the creation of this lack of societal outrage at what
goes on in some professions/ institutions? If so, isn't this perhaps the biggest ethical
failing of all?
I think this module is going to be very, very interesting and challenging...