As a condition of membership, all ACHE affiliates must agree to abide by ACHE’s Code of
Ethics. But in a rapidly changing environment characterized by mounting challenges, new
relationships, and rapid technological change, even the best-intentioned healthcare executive
is likely to struggle with certain ethical dilemmas.
ACHE’s Ethics Self-Assessment is designed to help executives and managers identify areas
in which they stand on strong ground, areas in which they feel less grounded, and opportunities
for future reflection. This tool is intended for individual use and should not be returned to
ACHE. In addition, it should not be considered a tool for evaluating others’ ethical behavior.
How to Use the Ethics Self-Assessment
The Ethics Self-Assessment can be used in several ways. Since the self-assessment is published
annually in Healthcare Executive magazine and posted on ACHE’s Web site, any leader may complete
this tool at his or her convenience to help increase self-awareness. Similarly, as part of regular
performance reviews, employees can be given the tool to facilitate self-reflection or personal
development. However, please note that it should be used uniformly so as not to single out a
particular individual. Completing the Ethics Self-Assessment should be a voluntary, personal
matter and not used as the basis for performance evaluations. The usefulness of the assessment
is based on honest responses to each question.
The self-assessment can also be used as a component of ethics training or employee
orientation, or used by executives within the context of their organizations to
foster discussions about the importance of ethical behavior. For instance, the
nurse managers at your hospital might agree to each fill out the Ethics Self-Assessment,
not with the intention of sharing their results, but with the intention of using the
self-assessment as a springboard to further ethics discussion. The nurse managers can then be
brought into a discussion about how they felt while filling out the assessment, and
whether it brought to mind any ethical issues within the organization or areas requiring
further discussion.
Reviewing Results of the Ethics Self-Assessment
After finishing the self-assessment, review your responses, especially noting which
questions you answered “usually,” “occasionally,” and “almost never.” You may find
that in some cases, an answer of “usually” is satisfactory. But in other instances,
such as when a question asks about protecting staff’s well-being, an answer of “usually”
may raise an ethical red flag. You will note that the instrument does not have a scoring
mechanism; this is intentional. We do not believe that ethical behavior should be quantified.
It is quite natural to uncover a few ethical red flags; when you do, there are several ways
to appropriately address them. It may be the case that some questions described situations
in which you were unsure about what the ethical course of action would be or your organization’s
policies concerning the situation. You may want to discuss these questions with an ethics
resource at your organization, such as the chair of the organization’s ethics committee.
You should also consider your professional society as an additional resource when you and the
management team are confronted with difficult ethical questions. You can refer to the regular
“Healthcare Management Ethics” column in Healthcare Executive as well as ACHE’s Ethical Policy Statements. Finally, you may want to consider attending ACHE’s annual ethics seminar, held at
the Congress on Healthcare Management.
ACHE Feedback
Although the self-assessment is not designed to be returned to ACHE for evaluation, we appreciate
any feedback you might have regarding the use of the instrument. For example, did you find the
instrument helpful? Were there questions that you did not understand or that needed clarification?
Do you have suggestions or thoughts regarding the use of the self-assessment? To submit feedback,
please contact Deborah J. Bowen, FACHE, CAE, executive vice president and chief operating officer.
