Letter to the Editor by Roethler on Whistleblowing As a Failure of Organizational Ethics

Administrative Ethics: What's Your Integrity Quotient (IQ)?

Response by Courtney Roethler to 'Whistleblowing as a Failure of Organizational Ethics' by James J. Fletcher, PhD, Jeanne M. Sorrell, PhD, RN, and Mary Cipriano Silva, PhD, RN, FAAN (December 31, 1998)
Reply by Author

April 28, 2008

Dear Editor:

I recently read the article by Dr. Fletcher and colleagues entitled, 'Whistleblowing as a Failure of Organizational Ethics,' and am finding the article extremely informative and beneficial to my practice. Before reading this article, I had never considered the potential influence the Joint Commission on the Accreditation of Healthcare Organization (JCAHO) might have regarding issues in health care organizations. However, I was not surprised to read that most organizational moral codes address the business and financial aspects of health care, but not the clinical aspects of care. Likely this is because the individuals responsible for meeting the organization's financial '˜bottom line' are the persons writing these codes.  I have often heard staff raise ethical concerns over questionable practices within my organization, yet state that bringing these concerns to the attention of the administration would be futile. I don't believe that these codes will change and become more patient focused and staff focused until the organizations receive pressure from powerful bodies such as JCAHO. I encourage JCAHO to insist that health care organizations' reward system both be closely correlated to its published values and provide protection for employees who speak out on behalf of patient rights. I also commend Johnson & Johnson for recalling Tylenol during the Tylenol contamination incident, as described in this article, even though this recall cost the company millions of dollars. I found fact that there was no questioning of money versus patient safety in this situation to be uplifting.  Thank you for publishing such an informative article addressing this important issue.

Courtney Roethler, RN, BSN
San Jose State University MSN Student
Staff Nurse Emergency Department
Fremont, CA