University Assignment: Business Ethics and NHS Conflict of Interest

This report analyzes business ethics and responsible management, focusing on a case study of conflict of interest within the NHS concerning gifts and hospitality. The first part of the report presents an analysis of the case, considering stakeholders, the role of the NHS in society, and recommendations for ethical practice. The second part assesses the case using ethical theories such as Naturalism and Utilitarianism. The final part reflects on ethical leadership, the role of an ethical manager, and conditions leading to unethical practices within organizations. The report emphasizes the importance of ethical decision-making and the critical role of ethical conduct in healthcare, highlighting the impact on patients, the community, and the overall integrity of the healthcare system. The analysis draws on various academic sources to support its arguments and recommendations, providing a comprehensive overview of the ethical challenges and potential solutions.

Running head: BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
Business Ethics and Responsible Management
Name of the student:
Name of the university:
Author note:

2BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
Table of Contents
Introduction:....................................................................................................................................3
Part 1-A: Report...............................................................................................................................3
Introduction:................................................................................................................................3
Reason of considering NHS gifts and hospitality: The case of conflicts of interest as an ethical
question:.......................................................................................................................................4
The role of business in the society:..............................................................................................6
Key stakeholders, who might be affected by this activity of NHS:.............................................7
Conclusion and recommendation:...............................................................................................8
References:......................................................................................................................................9
Part 1-B: Assessment of the case by using ethical theories...........................................................12
References:....................................................................................................................................14
Part 2- Reflection on business ethics:............................................................................................15
What makes an ethical leader?..................................................................................................15
Role of the ethical manager to manage the high ethical standard in business:..........................15
Condition that brings unethical practice in an organization:.....................................................16
References:....................................................................................................................................17
Conclusion:....................................................................................................................................18
2

3BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
3

4BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
Introduction:
Business ethics is one of the most significant forms of professional ethics which support
in examining the ethical principles and thereby mitigate the issue that can arise at any point of
time during business. In the highly volatile business environment, the inclusion of business
ethics plays a major role in terms of leading individual people to take decision regarding right or
wrong. Present paper will put forth the discussion of business ethics. In the first part, the case on
NHS gifts and hospitality: The case of conflicts of interest has been chosen. In this part, the
case will also be assessed through ethical framework. In the last part, ethics in the context of an
organization will be evaluated.
1. Part 1-
1.1 Report to the senior manager of NHS:
1.1.1 NHS gifts and hospitality: The case of conflicts of interest:
Conflict of interest is one of the most challenging issues, being faced by NHS in the
contemporary times. It has been reported that lobbying is one of the major factors, leading to
conflict of interest among the staffs. As perceived by Grundy et al. (2018) it is expected that, the
staffs will ban the gifts over £50. Such negative attitude among the staffs has been considered as
the first national conflict of interest (The Telegraph. 2019). A new rule has been developed in
order to swipe away the cloud in dealing with the lobbyists. According to this term, it is the
obligation for the staffs and doctors to keep the record of dining worth more than £25, unless the
gift worth £50 will be banned (Nie et al. 2018).
4

5BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
Currently, NHS England is encountering with a series of scandals for the doctors, who
are associated in the pay with that of the drug managers. It is true that application of appropriate
medication plays a major role in mitigating the health related issues among the staffs. Still, the
association in between the doctors and the drug firms is absolutely a question of ethics. Tai and
Hsu (2018) stated that the issue of ethics and economic efficient is a major concern the entire
health and social care sector of UK. However, the relationship in between the medical
practitioners and the drug firms is a serious matter of concern for both the healthcare sector along
with the broader community. Both the doctors and the drug companies share common interest.
Weinstein (2019) observed that both of them are highly dedicated to use effective drug in the
treatment and care for the sake of lowering the health related issues among the patients.
The patients are the primary stakeholders of the health and social care industry while the
drug companies are the secondary stakeholders. The interests in between these patients are
different from each other, which is resulting in greater conflict of interest within the health and
social care sector. Sah et al. (2019) showed that the entire drug industry can have a major
contribution on the medical knowledge and practice. It has been perceived that the cost of drug is
more than US$500. In addition to that, the cost of clinical research is extremely high, which is
also contributed by the drug industry. In-spite of such contribution, the association in between
the doctors and the drug industry is a major matter of concern in the contemporary times. It has
been perceived that the relationship in between doctors and drug companies is playing a critical
role in accomplishing the fundamental objectives of the pharmaceutical industry. In addition to
that, based on the discussion of Rose, et al. (2019) it can be said that the association in between
the doctors and drug companies is also supporting the doctors to carry out the medical research
5

6BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
in a timely and cost effective manner and thereby compromising the ethical obligations of the
doctors to the patients.
Sox (2017) opined that the association in between doctors and drug companies is also
affecting the decision making capability of the doctors by restricting them to carry out in-depth
assessment of data independently. It is worthy to note in this context that these above mentioned
issues have been identified by the professional bodies, which are bestowed with the power of
developing the ethical code of conduct for both the doctors and the healthcare practitioners. The
fundamental aim of doctors behind developing relationship in the health and social care context
is to promote patient welfare, community welfare, and pecuniary interests such as consultancy
fees, share holdings, paid employment, hospitality and participating in the medical research.
Still, Bero (2017) argued by showing the fact that when the doctors frame relationship with that
the pharmaceutical company, the interest in between the doctors and pharmaceutical company
overlap each other and hampers the way providing high quality of treatment and care to the
patients, which is the fundamental objective of the health and social care sector (Denecke et al.
2015).
HCA International is one of the largest healthcare providers of UK, which is highly
committed towards aligning ethics with that of their internal functionality. This is being
considered as the largest ethical company across the world. The company has more than 250,000
colleagues who possess a strong sense of purposes in order to promote the health and wellbeing
of the patients and thereby enrich the community in which they are operating. In addition to that,
protecting the environment and reducing the degree of energy emission is the critical ethical
practices followed by the companies (Investor.hcahealthcare.com.2019).
6

7BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
1.1.2 The role of NHS in the society:
Respecting the fundamental human right of the people and practicing equality while
treating with the people are the most significant aspects of NHS.
The NHS is entirely belongs to the people. NHS is highly committed towards promoting the
health and wellbeing of the people and thus enables them to be mentally and physically well.
NHS follows a common set of principles and values which align them with the community in
which they are operating. NHS is operating fairly and effectively for the sake of serving the
people and protects their health and wellbeing (GOV.UK. (2019). It does not follow any kind of
discrimination on the basis of race, religion, physical status and gender. The services provided by
NHS have been designed in such a manner which intends to diagnose and treat severe health
related issues.
1.1.3 Key stakeholders, who might be affected by this activity of NHS:
The healthcare sector comprises of wide ranges of stakeholders, who are facing major
challenges due to the unethical relationship in between the doctors and the drug companies. The
patients are the fundamental stakeholder for the health and social care industry, who are largely
affected by the unethical relationship in between the doctors and the drug companies. It has been
observed by Baldwin (2017) that, the drug companies develop effective relationship with the
doctors for the sake of attaining effective commercial outcome. Sometimes, both the doctors and
the drug companies share same interest, which leads them to compromise in the way of carrying
out effective treatment of the patients.
It has been observed that the relationship in between the doctors and the drug companies
tend to influence the prescribing attitude of the doctors. Attractive gifts in the form of money
drive the doctors to prescribe the medicines from costly brands (Baldwin 2017). This is the
7

8BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
reason, for which the doctors sometimes are behaving in such a manner, which is entirely
opposite to that of the code of ethics. In this way, the unethical relationship in between the
doctors and the drug company is affecting the professional behavior of the doctors. The
community is a also a vital stakeholder, who is also encountering major issues due to the
unethical relationship in between the doctors and the drug companies (Denecke et al. 2015).
1.1.4 Conclusion and recommendation:
Based on the discussion, it can be conclude by saying the mutual; interest in between the
doctors and the drug companies is leading the doctors to compromise with the treatment of the
patients. It is recommended for the trusty board of the hospital to take necessary actions in order
to control the unethical relationship in between the doctors and the drug companies. It is
recommended for the hospitals to incorporate healthy behavior among the nurses and allow them
to take part in the decision making process as they also possess effective knowledge regarding
the medications and treatment (Sox 2017).
The role of whistle blowing is needed to be considered in this context as it will help in
exploring the underlying issues in an effective manner. It is suggested for the trusty to create the
internal environment in such a manner, in which the nurses can raise the questions related to
ethics address them properly. It is recommended for the trusty board of hospitals to practice code
of ethics which needs to be followed by all of the staffs. As the doctors are engaged in the illegal
relationship with the doctors, it is suggested for the trusty board of the hospital to ensure that all
the doctors are following the code of ethics in the way of performing their duty as the healthcare
service provider.
8

9BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
1.2 Assessment of the case by using ethical theories:
1.2.1 Description of ethical theories:
According to the Naturalism theory, ethics is highly dependent on the moral judgment
and psychology. However, Bowling and Glantz (2019) argued by putting stress on the fact that in
different social condition, the moral judgment and code of conduct of the people differs. This
theory state the fact that all the people tend to have identical psychological tendency. Still,
different situations play a critical role in terms of changing their tendency.
According to the Utilitarianism theory of ethics, it is imperative to assess both positive
and negative outcome of an activity before carrying out it. When actions increase happiness, then
it can be considered as good (Tai and Hsu 2018). The changing prescribing attitude of the
customers due to the interaction in between them and the medical practitioners might affect the
treatment of the patients. This is the reason for which it can be said that the unethical relationship
in between the doctors and the drug company is a negative action, which might affect the health
and wellbeing of the patients.
1.2.2 Application of the Theories to the Issue:
The practice of interaction in between the doctors and the drug companies is accelerating
in a rapid manner. However, as the drug companies are only concerned with the financial
outcome, they tend to influence the prescribe behavior of the doctors by offering them with
lucrative gifts (Lichter 2017). In addition, it has also been observed that the sometimes, the
doctors are compromising with the treatment of the patients.
Based on the Naturalism theory it can be said that it is true that providing high quality of service
to the patients and thereby promote their health and wellbeing. However, the association in
9

10BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
between them and the drug companies is affecting their attitude in the contemporary times
(McKi et al. (2016). Wide ranges pleasure trips in the country and abroad for the doctors and
their family members are also arrange by the drug companies. This is affecting the prescribing
attitude among the doctors (Lichter 2017). The doctors tend to prescribe the medical products of
these companies even after compromising with the treatment of the patients. Thus, it can be said
that, the lucrative offers provide by the drug companies is affecting the behavior of the doctors
and preventing them to act in accordance with the ethical code of conduct. This theory is highly
accurate and results in realistic reaction to the subject. This theory states that there is no outside
force that can trigger the emotion of the subjects. This is so with the case of doctors. They
believe that taking gifts in the form of money is not at all unethical. However, Lichter (2017)
argued that the opponents of this theory believe that the researchers lack the ability to control the
environment which can affect the behavior of the subjects.
Braithwaite et al. (2015) showed that Utilitarianism theory follows democratic practices which
are the fairest way of making effective decision. By considering this theory, it can be said that it
is the general perception among wide range of doctors that maintaining relationship with the
drug companies and accepting the gifts such as pen, calendar, pen stand, diner funded by the
companies are not at all ethical. Yet, accepting extremely costly gift is unethical.
1.2.3 Disadvantages of the Selected Ethical Theories:
Horne (2018) argued by saying that Naturalism theory is used highly in terms of
comparing and validating results apart from the unstructured observation. By using this theory,
more comprehensive information regarding the relationship in between the doctors and the drug
companies has been acquired. On the contrary, Bowling and Glantz (2019) contended on the
ground that the result of the naturalistic observation can be different. Still, it is imperative to note
10

11BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
here that this theory put stress on the fact that human nature is highly versatile. In addition,
according to this theory, the human instincts and impulses should be expressed properly. On the
other hand, Utilitarianism theory also utilizes the objective process in order to make effective
decision. However, Tai et al (2018) argued by saying that the outcomes of the study, conducted
through this theory is highly predictable which makes it difficult to understands the human
behavior properly.
1.2.4 Recommendations for Improvements to the Issue based on the Theories:
As the unethical relationship in between the doctors and drug companies is posing a
major threat in the way of treating the patients properly, NHS should take to resolve such
unethical practices. Based on Naturalism theory, it can be said that NHS should develop the
healthcare system by aligning effective ethical framework which should be followed by the
doctors and other healthcare practitioners. The ethical framework must also be used in the
decision making which can help in improving trust and confidence among the patients. Medical
ethics is one of the major branches of moral philosophy, which supports in dealing with any kind
unethical issues while treating the parties. By taking reference from Utilitarianism theory, it is
suggested for NHS to set code of conduct which must be followed by the doctors in order to
improve health outcome. It is suggested for NHS to follow patient-centered approach in order to
provide high quality of services to the patient without following any kind of unethical practices.
11

12BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
2. Part 2
2.1 Reflection on Ethical Leader and Personal Ethics:
2.1.1 Definition of an Ethical Leadership Management in an Unethical
Organizational Culture:
Maintaining ethics is one of the major ways of attaining long term success from business.
I have learned that the ethical leaders possess the ability to do the right thing by aligning all the
vital resources in an effective manner. Crane et al. (2019) showed that fairness and justice are the
crucial factors that make an ethical leader. I have learned that the ethical leaders practice equality
in the way of treating the human resources. The ethical leaders avoid showing biased attitude in
the way of treating the employees on the basis of age, gender, race and cultural background
(Hunter 2018). Showing respectful attitude for the others is another major skill that makes the
ethical leaders. As highlighted by Trevino and Nelson (2016) showing respect to all the team
members, acknowledging their contribution and allowing them to take part in the decision
making process are the key traits of successful ethical leaders. Honesty and loyalty is another
major characteristic feature of successful ethical leaders (Orthwein 2017).
2.1.2 Process of Maintaining Integrity and Compliance in an Unethical Environment
of Business:
According to Berwick (2016) the inclusion of unethical practices in business affects the
organizational productivity and makes it difficult to maintain long term relationship with that of
the customers. Unethical leadership is one of the major unethical issues in an organization.
Evidences are showing that lack of effective ethical skills sometime leads the business leaders to
12

13BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
follow unethical practices such as manipulating the report and the financial planning (Trevino
and Nelson 2016). I have learned that the managers are highly responsible for the workplace
misconduct, which ultimately leads to inappropriate leadership. Ethics and moral principle play a
major role in practicing high standard of ethics in an organization. Thus, being the ethical
manager, it is my primary role to ensure that I am well trained in practicing business ethics and
legal standards in order to deal with any kind of business related challenges. Shaw (2016)
commented that practicing compliance is one of the vital ways, through which high ethical
standard can be maintained. As the ethical leader, it is my duty to practice compliance and ethics
program in order to keep the employees informed regarding the ethical standards. In addition to
that, I must help the human resources to accelerate their ethical decision making skill. According
to Barry (2016) it is the prime responsibility of the ethical managers of the organizations to
establish a comprehensive system in terms of keeping the management concerned regarding any
kind of issue, which is restricting the way of accomplishing organizational goals and objectives.
2.1.3 My Own Experience and Knowledge with Example to work in an Ethical
Business Environment
As the ethical leader, it is my responsibility to conduct ethical training program for the
staffs. Implementation of whistle blowing strategy is also a major role of the ethical leaders. In
the workplace, some of the employees were showing negative attitude in the way of performing
their task with efficiency. With the assistance of whistle blowing strategy, I have identified those
employees and taken necessary action against them. Being an ethical leader, it is my duty to
implement this strategy in order to figure out any kind of negative attitude in in the organization.
McCloskey (2017) said that the information, collected from the whistle blower is to be kept
confidential in order to take relevant decision.
13

14BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
Conclusion:
Based on the discussion, it can be concluded by said that unethical practice in the
business is the most critical issue, which can hamper the internal functionality of a business.
However, there are certain ethical issues, which can have a firm impact on restricting a firm in
the way of accomplishing organizational objectives. Maintaining ethical standard plays a major
role in keeping the staffs motivated, which is the key of generating happiness among the
customers by offering them with high quality of products.
14

15BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
References:
Baldwin, M., 2017. Care Management and Community Care: Social Work Discretion and the
Construction of Policy: Social Work Discretion and the Construction of Policy. Routledge.
Barry, N., 2016. Business ethics. Springer.
Bero, L. 2017. Addressing bias and conflict of interest among biomedical
researchers. Jama, 317(17), 1723-1724.
Berwick, D. M. 2016. Era 3 for medicine and health care. Jama, 315(13), 1329-1330.
Bowling, C.M. and Glantz, S.A., 2019. Conflict of Interest Provisions in State Laws Governing
Medical and Adult Use Cannabis. American journal of public health, 109(3), pp.423-426.
Braithwaite, J., Wears, R.L. and Hollnagel, E., 2015. Resilient health care: turning patient safety
on its head. International Journal for Quality in Health Care, 27(5), pp.418-420.
Crane, A., Matten, D., Glozer, S. and Spence, L., 2019. Business ethics: Managing corporate
citizenship and sustainability in the age of globalization. Oxford University Press.
Denecke, K., Bamidis, P., Bond, C., Gabarron, E., Househ, M., Lau, A.Y.S., Mayer, M.A.,
Merolli, M. and Hansen, M., 2015. Ethical issues of social media usage in healthcare. Yearbook
of medical informatics, 24(01), pp.137-147.
GOV.UK. (2019). The NHS Constitution for England. [online] Available at:
https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-
constitution-for-england [Accessed 24 Aug. 2019].
15

16BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
Grundy, Q., Dunn, A.G., Bourgeois, F.T., Coiera, E. and Bero, L., 2018. Prevalence of disclosed
conflicts of interest in biomedical research and associations with journal impact factors and
altmetric scores. Jama, 319(4), pp.408-409.
Horne, M., 2018. Values in social work. Routledge.
Hunter, D.J., 2018. Desperately seeking solutions: rationing health care. Routledge.
Investor.hcahealthcare.com.2019. HCA Healthcare Named A World’S Most Ethical Company
For 10Th Consecutive Year | HCA Investor Center. [online] Available at:
<https://investor.hcahealthcare.com/press-release/hca-healthcare-named-worlds-most-ethical-
company-10th-consecutive-year> [Accessed 6 August 2019].
Lichter, A. S. 2017. Conflict of interest and the integrity of the medical
profession. Jama, 317(17), 1725-1726.
McKie, J., Singer, P. and Richardson, J., 2016. The allocation of health care resources: An
ethical evaluation of the'QALY'approach. Routledge.
Nie, J.B., Cheng, Y., Zou, X., Gong, N., Tucker, J.D., Wong, B. and Kleinman, A., 2018. The
vicious circle of patient–physician mistrust in China: Health professionals’ perspectives,
institutional conflict of interest, and building trust through medical professionalism. Developing
world bioethics, 18(1), pp.26-36.
Orthwein, W.C., 2017. Psychiatric and mental health nursing: The craft of caring. CRC Press.
Rose, S. L., Sah, S., Dweik, R., Schmidt, C., Mercer, M., Mitchum, A., & Robertson, C. (2019).
Patient responses to physician disclosures of industry conflicts of interest: A randomized field
experiment. Organizational Behavior and Human Decision Processes, 8(7), pp. 8-120.
16

17BUSINESS ETHICS AND RESPONSIBLE MANAGEMENT
Sah, S., Loewenstein, G. and Cain, D., 2019. Insinuation anxiety: Concern that advice rejection
will signal distrust after conflict of interest disclosures. Personality and Social Psychology
Bulletin, 45(7), pp.1099-1112.
Sox, H. C. (2017). Conflict of interest in practice guidelines panels. Jama, 317(17), 1739-1740.
Tai, M. C. T., and Hsu, P. Y. 2018. Good Practice Against Conflict of Interest and Bias in
Biomedical Research. Taiwan Medical Education Association, 22(2), 82-88.
The Telegraph. 2019. NHS Ban On Staff Receiving Gifts Worth More Than £50 In Crackdown.
[online] Available at: <https://www.telegraph.co.uk/news/2016/09/20/nhs-ban-on-staff-
receiving-gifts-worth-more-than-50-in-crackdown/> [Accessed 3 August 2019].
Trevino, L.K. and Nelson, K.A., 2016. Managing business ethics: Straight talk about how to do
it right. John Wiley & Sons.
Weinstein, R. A. 2019. Clarification of errors in Abbas et al.’s conflict of interest narrative
review. Intensive care medicine, 45(1), 128-129.
17