Ethical Considerations in Healthcare Design and Construction

Abstract

Perhaps some of us take ethical conduct in personal relationships and busi- ness situations for granted. Unfortunately, while most of us attempt to live a highly ethical life, there are often breaches in ethical conduct that we may dismiss as fair and usual business practices, or some may simply disregard the need to be ethical in their attempt to be selected for project.The following case studies illustrate how easily one's conduct can breach ethi- cal standards. The aim of this article is to introduce the four principles and four behavioral standards of ethical conduct. While some ethical situations are not obviously right or wrong, others are more clear-cut. Each of the cases below illus- trates a specific ethical principle.Case 1-Jeff is the Business Development Director for a national construction com- pany with a local office that specializes in healthcare construction. He notices that his company never receives notice of projects from one of the local hospitals. Although he visits with the director of facilities for the hospital, shares his company's experi- ence and expertise, and participates in the fund-raising activities for the hospital, he realizes that his company never receives requests for proposals (RFPs). In one of his visits with the Director of Facilities, he asks her if there is a reason that his company is not considered. She reassures him that his company has an excellent reputation for safety and quality in construction, and that she will ensure that he receives an RFP in the future. Jeff is later informed by a colleague that the Director's assistant previ- ously worked for a construction company and that the same company is highly favored by the hospital in spite of its lack of healthcare construction experience. Later it is revealed in the news that the president of the construction firm donated $1.5 million to the hospital's foundation.Case 2 -Big Name Hospital System has decided to have a design competition among architects for its new Heart Center, which will be the flagship, state-of-the-art hos- pital for the entire system. An RFP is sent out to a number of architectural teams with the terms for the design competition. The firms are notified that they will not be compensated for their design, that designs must meet certain space and budget cri- teria, and that the designs must be examples of evidence-based healing environments. The teams are given 4 months to complete their designs, and then they are expected to present the designs to the Executive Selection Team for Big Name Hospital System. The architects are expected to bring their updated space programs, schematic designs, and architectural renderings of how they envision the new Heart Center and evidence for their design features and solutions. After all of the architectural firms have pre- sented their prospective designs, the Executive Selection Team chooses two finalists. They inform the architectural teams that they like certain elements of their designs, but they request them to consider other design requirements and features that were presented by some of the architectural firms who were not selected as finalists. The executive team indicates that they really like the design presented by one of the previ- ous teams. They share the renderings and schematic designs of one of those teams to the finalists and ask them to take them into consideration in their final presentations for the project. Approximately a year later, Steve, who is the Managing Partner for a large architectural firm that was considered in the design competition but was not selected as one of the two finalists, notices that the new Heart Center for Big Name Hospital System has won a design award by a very prestigious organization. When he reviews the small schematic design and the rendering for the new Heart Center, he is shocked to realize that it is nearly identical to the design that his architectural firm submitted and presented to the executive team at Big Name Hospital System. …