Measuring the Value of Ethical Frameworks
A central focus of our work at Canmore Ethics is thinking about how organizational processes influence outcomes. We regularly find that when ethical issues occur, it’s not because of bad people acting negligently, but because the organization had no process for identifying and addressing ethical risk. Different tools exist for correcting this gap. One is a code of conduct; another is an ethics framework. Both of these are useful, but their value can be exaggerated. We have already explored the limits of codes of conduct in a previous article. Here, we discuss ethical frameworks.
There is wide variation in what ethical frameworks try to achieve and what people mean by the term. In some cases, a framework simply lists guiding principles and some implications of them. For example, the Government of Ontario has an “Ethical framework for COVID-19 vaccine distribution,” which lists various principles to follow—equity, fairness, etc.—that decision makers should adhere to, giving specific guidance on a Covid-19 vaccine distribution. In other cases, ethical frameworks are designed to be used more broadly. Trillium Health Partners, a hospital with three main sites in Ontario, has a framework designed with the following in mind:
The purpose of the IDEA: Ethical Decision-Making Framework is to provide a step-by-step, fair process to help guide healthcare providers and administrators in working through ethical issues encountered in the delivery of healthcare. The Framework can be used to guide decision-making and actions about ethical issues that arise from the bedside to the boardroom (link).
Frameworks of this sort guide users through the process of ethical decision making and, in general, are meant for people who are not experts in ethics but are still in a position of needing to make a decision. Since they have steps decision makers can follow, they are helpful when a possible resolution for an ethical issue is unclear or when possible outcomes conflict with each other.
Framework benefits
The biggest benefit of an ethical framework is that it offers a standardized process for decision making. This is attractive, especially for leaders who are not used to making decisions explicitly with ethics in mind. While frameworks are most common in healthcare, organizations in other industries are adopting them. Most frameworks are purposefully flexible, designed, as the IDEA framework is, to be used whenever an ethically complex decision needs to be made, regardless of what the decision is about. They accommodate many different scenarios and groups. Because of this, organizations of all types might find it helpful to use ethical frameworks for decisions that they identify as ethically complex.
Another potential benefit of ethical frameworks is that they guard against ethical fading, which occurs when people overlook the ethical implications of their decisions. One strategy to avoid ethical fading is to make ethics an explicit part of the decision-making process (we discuss the importance of explicit values-based decision making in this insight article). Using a framework is one tactic for operationalizing explicit values-based decision making.
The limits of ethical frameworks
A central limitation of ethical frameworks is that there is no quality check or standard when using or developing ethical frameworks. We have conducted an extensive literature review and, to our knowledge, and despite the hundreds of frameworks in existence, none has been validated or studied to see how it affects decision making relative to another framework (or no framework). Despite their popularity, there is only circumstantial evidence that frameworks lead to better decision making. Since any organization or person can make an ethical framework, and it can be difficult to assess quality, there is effectively no way to determine reliability.
This causes other problems. Each of the hundreds of different frameworks differ from each other, and some might be more or less well suited for the decision maker’s purpose. Frameworks still rely on the people using them and the degree to which these users can consider the complexity of an ethical situation. There is also a high degree of variability when using frameworks. Many follow the Trillium IDEA approach of being designed for a broad range of decisions, but many do not offer the robust instructions the IDEA framework does. Additionally, frameworks are not algorithms. They do not aim to produce a consistent result if followed appropriately. This leads to the serious risk that frameworks will give decision makers a false sense of confidence when, in fact, the framework can be another source of ethical risk. They are also not an effective means of minimizing bias, since, in most frameworks, the decision makers still decide which values are relevant.
Fantastic frameworks and where to find them
In our view, the value of frameworks is often overrated. Leaders sometimes view developing a framework and code of conduct as sufficient for being an ethical organization, but this is a mistake. While frameworks might be helpful in some situations—and more easily accessible than an ethicist—they are not an appropriate replacement for other organizational processes and, when needed, formal ethics consultation. Our preferred approach is to establish processes for identifying and addressing ethical questions, which can include using an ethical framework, but is not limited to doing so. Care should also be taken to avoid blind spots in decision making. An appropriately diverse group or an independent ethics expert can help.
There is no clear answer to what makes a quality ethical framework, nor which framework is best for a given situation. It is always best to approach ethical frameworks with caution and remain critical of the ethical situation you face.