Ethics in Action: BOC Facility Principles: It’s all well and good until …

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February 25, 2016

By Kimberly S. Peer, EdD, ATC, FNATA

The Board of Certification (BOC) created the BOC Facility Principles document and the accompanying online resource as tools for secondary and post-secondary programs to self-assess their compliance with best practices for facility management. Both resources provide a checklist designed to assist Athletic Trainers (ATs) and other relevant personnel including but not limited to human resources management, principals and athletic directors to provide a safe, effective and legally sound healthcare environment.

As an AT, it is your professional obligation to review the document and utilize the checklist to ensure an optimal environment. However, what happens when you find your facility is not compliant with these guidelines and your administration or superiors choose not to act to remedy the problem? What is your legal and moral obligation to ensure these principles are enacted in your facility? What is your responsibility if you continue to practice in this environment when you discover you are not compliant and nothing is being done to bring the facility in alignment with these best practices?

A major ethical dilemma occurs when you know there is a problem and your administration ignores the problem. If you stand up for what you know is right, you risk losing your job or facing other alienation tactics. If you continue to offer services despite the lack of compliance, are you doing what is right and good? Are you responsible if something bad happens even if it was your superior or administrator who chose not to remedy the problem? How far are you willing to go to demonstrate moral courage and do what is right? What are the potential ethical and legal consequences if you ignore your findings? How would you handle this situation if your administrator chose not to remedy the problems you found?

Moral courage requires that we stand up even when we could potentially face exposure or significant loss. Moral courage is reflected when we stand up for what is right despite potentially harmful consequences, personally and professionally. But this is easy in theory, hard in practice. Where do you draw the line and decide it is worth the fight for what is right? How do you decide when values such as loyalty to the employer and your patients conflict with honesty regarding potentially harmful environmental issues in the facility?

Although guidelines and principles provide a strong foundation upon which to guide your practice, they are not all-inclusive nor do they always carry consequences if not followed. But ethical behavior should not be regulated by policy or guidelines; it should be inherent in all we do as professionals. A wise man once said, “In matters of principle, stand like a rock. In matters of preference, go with the flow.”

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