The Ethicist: Transparency (Part II)

I have been a member of a number of ethics committees in local health care organizations for a number of years. Entering an ethics meeting at one of these institutions shortly after Christmas, I was surprised to see boxes of chocolates all over the staff room. When I asked whether there were an unusual number of chocoholics among the employees, I was told that these were Christmas gifts given to employees by the clients of the organization. Staff members were not allowed to accept personal gifts, no matter how small, but could not always refuse without causing hurt or offense, so all such presents had to be declared publicly and shared.

By M0tty (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

A chocolatey conflict of interest? (Photo by M0tty, own work, CC BY-SA 3.0, via Wikimedia Commons)

The reason staff were not allowed to keep gifts was that allowing them to do so might create the perception or the reality of a conflict of interest: those who gave gifts might come to expect a higher level of service than those who didn’t, and the more expensive the gift, the higher the expectations on one side and the feelings of obligation on the other. Better to allow no gifts at all or, when they absolutely could not be avoided without insulting the gift giver, make them public and shared with everyone, so they ceased to imply any kind of contract between the gift giver and the receiver.

All ethics committees I know of take conflicts of interest seriously and set out very strict and clear guidelines for employees about how to avoid both the perception and the reality of a conflict of interest. Conflicts of interest are usually understood to have two distinct, though related, dimensions. The first kind of conflict is generated by a situation in which the parties have incompatible aims or goals which challenge the professional obligations of one or the other, such as a case in which a resident of a long-term care home tries to ensure special care for herself by offering gifts to a personal support worker, who has the professional obligation to treat all residents equally.

The second kind of conflict is generated by a situation in which an individual can personally benefit from a decision he makes in his official capacity, such as when a businessman is elected to public office, and then makes decisions that benefit his company. Conflicts of interest – potential or actual – are taken so seriously in the ethics committees that I am on that not only do organizations prohibit their employees from accepting gifts, most also require each member of the committee to declare, at the beginning of each meeting, whether any of the agenda items to be discussed put a member in a conflict of the second sort. Those in conflict must excuse themselves from the conversation (and the room) when that item is considered.

 

No big deal?

Conflicts of interest are not complicated to understand or difficult to avoid: they basically boil down to the injunction not to accept favors or gifts that might conflict with our professional duties, and not to do things in our professional capacity that might benefit us personally. Everyone working in a long-term care home, for example, from a personal support worker at one end of the employment ladder to the director, at the other, could tell you what a conflict of interest is, and how to avoid finding yourself caught in one. However, this is a concept that politicians on both sides of the border seem to be struggling with: Donald Trump’s business interests seem entirely entwined with his political role, and Justin Trudeau – sadly – seems unable to recognize that taking an all-expenses paid family vacation from someone whose organization lobbies the Canadian government for money is a breach of basic conflict of interest rules, an act far more egregious than accepting a box of chocolates from a nursing home resident. He is now, at the time of writing, the subject of an ethics inquiry, and rightly so.

Justin Trudeau By Radio Television Malacañang (RTVM) (source) [Public domain], via Wikimedia Commons

Justin Trudeau (Photo by Radio Television Malacañang, Public domain, via Wikimedia Commons)

Some of you might be wondering what the big deal is, and why we should care. I have heard supporters of the prime minister say things like “Give him a break! He deserves a family vacation,” and “The Aga Khan Foundation does good work,” both of which may be true, and both of which are utterly irrelevant to the ethical issues conflicts of interest raise. Last month, I wrote about the importance of the principle of transparency for public institutions in a democracy: I now want to extend the point to more explicitly cover our politicians as well. It is not only our public institutions that we should be able to “see through,” metaphorically-speaking, but our elected representatives as well. Or, to put this point another way, if our politicians aren’t the ethical versions of those illustrations in anatomy texts, which allow us to see the structures that lie under our skins, then the institutions in which they work can never be fully transparent, either. We need to know that the decisions they make, whether or not we agree with them, were at least made on the basis of their best understanding of what advances the public interest.

If the current government gives new money to the Aga Khan Foundation we will never know for sure whether it did so because our prime minister believes it is a worthy organization for Canadians to support, or because he accepted a “free” holiday from the organization’s founder. Moreover, Trudeau can never, now, be certain himself: he may feel that the gift of a vacation in the sun had no bearing on the contribution, but he has put himself in a situation of conflict of interest, and generated an obligation to someone who stands to benefit from his public role.

Studies have shown that physicians who accept gifts (even small ones) from pharmaceutical representatives change their prescribing practices even when they believe that the gifts have had no effect on them. This is why conflicts of interest are so insidious: they often arise because we like certain people, and want them to think well of us – and, by the time we realize that we are caught in one, it is already too late to back out. This is why people working in long-term care know that even accepting the gift of a box of chocolates creates a conflict of interest, either perceived or actual (and, given the nature of such conflicts, perception, in a very real sense, becomes reality). The person receiving the gift, were he to keep it for himself, incurs an obligation to the person giving it, and can never be entirely certain that the gift has not subsequently affected how he treats the gift giver.

The actions and decisions of our politicians, in short, can only be appropriately transparent when they have avoided even the perception that they are enriching themselves through their public role, or using that role to help their friends. Even more disturbingly, it has been reported that the PMO initially tried to keep the Trudeau family’s vacation secret. These reports, if true, suggest that the prime minister’s staff knew that there was the potential for a real or perceived conflict of interest in the vacation details; the fact that the Trudeaus and their friends went anyway indicates either that the prime minister didn’t think that he would get caught, or that he didn’t care. Both possibilities show a real disdain for the basic ethical expectations around transparency and avoidance of conflict of interest that all politicians should know, rather than an ignorance of them (which would also, of course, be disturbing, but perhaps more forgivable).

 

Public vs. Private

Some of you might be tempted to respond, at this point, “But what about privacy? Isn’t the prime minister entitled to a private life?” Sure, of course he is. However, once someone chooses to enter public life, they have a responsibility to those who elected them to be honest about where they are, what they are doing, and who they are spending time with. The things done in private, that is to say, should not be things that will have an effect on their abilities to adequately and ethically fulfill their public duties. We don’t need to know the details of what the Aga Khan’s guests ate for dinner, or which rooms they slept in, but knowing who Trudeau holidays with (and who pays for the vacation) is legitimate public information, because it may affect his public policies. In short, once someone enters public life, the line between public and private is a narrow one, and, when in doubt about which side of the line something falls on, the public responsibilities must take precedence.

Aga Khan IV (Photo by UK Department for International Development, CC BY 2.0, via Wikimedia Commons)

I want to make it clear that the point I am making here is not a partisan one: I have, at times, supported the Liberal Party of Canada with both my vote and my money. But I have many friends for whom Stephen Harper could do no good, and for whom Justin Trudeau can do no evil. I ask any readers who might fall into this category to take what I will call the Harper test: how would you have responded if Stephen Harper had gone on a luxury, all-expenses vacation provided by a representative of a Foundation that lobbies the government? If you would have accused Harper of unseemly and unethical behavior (as you should), you ought to do the same with Trudeau.

What matters, when it comes to conflicts of interest, is the professional role of the person in question, not who they are as particular individuals, and not whether you find them likeable or not. Speaking as an ethicist, it’s very disappointing to see our prime minister fail the basic ethical requirement that he not place himself in a position of perceived or actual conflict of interest, a requirement which, to reiterate, is well understood by workers in long-term care, and expected to be met by their employers. He could have afforded to take his family on a nice Christmas vacation somewhere and did not need to have it paid for; and he could have chosen to spend it with people who were not likely to be asking the government for money. That he chose not to do these things is sad and ethically disturbing.

Rachel Haliburton
Wolfville native Rachel Haliburton teaches philosophy at the University of Sudbury. She is working on a book that explores the ethical dimensions of detective fiction.

 

 

 

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