Instructor: Charmaine J. Cummings, PhD, RN
by Michael S. Altus, PhD, ELS
I had been skeptical about the value of a workshop about ethics for medical communicators. Having written “AMWA Ethics FAQs”, I somewhat smugly assumed that there wasn’t much else to essential ethics for medical communicators besides ghostwriting, and there wasn’t much about ghostwriting that I hadn’t heard about. I was in for a humbling and highly worthwhile experience.
The workshop started with definitions of words such as “ethics,” “law,” and “morality.” Then Dr. Cummings, a continuing medical education professional, referred to AMWA’s Code of Ethics and to other codes of ethics.
But, as Dr. Cummings explained, codes of ethics are only guides. What to do?
The key strengths in the workshop, and what meant the most to me, were in finding about an answer to the question, “How should ethical situations be handled?”, and then in dividing up into groups to discuss handling case studies in ethics.
To answer the question about how to handle ethical situations, Dr. Cummings presented a highly useful process, “The RIGHT Decision”, which was developed by a group of AMWA members:
Recognize: What is the situation and why is it important?
Investigate: Why is the situation occurring, what are the facts, and how do ethics codes inform handling the situation?
Gauge: What are possible courses of action?
Handle: Should action be taken immediately or stepwise, and who else might be needed to implement the action?
Tailor: What are the lessons to be learned, and how might I need to change my own behavior?
Participants then divided up into groups of three or four to consider a case study in ethics to apply the RIGHT Decision. For example, in one of these case studies, a writer working for a contract research organization (an organization that provides research support services to client pharmaceutical and device companies) prepared a report showing statistically significant side effects in a study of a client’s new drug. Concerned that the pharmaceutical company client would take its business elsewhere, the writer’s supervisor asked the writer to “spin” the conclusions. What are ethical paths for the writer?
After about one-half hour during which the groups considered their cases, participants regrouped as a whole, and each group reported on its findings. I was greatly impressed by how much can be accomplished by having ethical situations be discussed in groups. However, in another case study, Dr. Cummings wrote that the situation “raises the big question of what to do in a situation where the powers that be do not have the same ethical standards as the writer.” I had the impression that participants were overly optimistic about outcomes in situations in which “the powers that be” would mend their ways and follow an ethical path.
The workshop had shortcomings. In preparing a case study for the precourse homework assignment, and in considering the case studies discussed during the workshop, I thought that I had to force myself to find an applicable principle in AMWA’s Code of Ethics. The introductory material provided during the workshop about AMWA’s history and educational program was unnecessary, and the discussion of AMWA’s Code of Ethics could have been shortened. The workshop fell behind schedule. But even so, the pacing did not feel rushed. The workshop’s shortcomings were amply compensated for by its “longcomings.” Dr. Cummings is a master teacher.
Ethical situations are uncomfortable to discuss and in other respects are difficult to handle. Meanwhile, medical communicators have justifiably been subject to criticism for their complicity in unethical practices such as ghostwriting. For the sake of our profession and for ourselves, we need hands-on ways to learn about and apply ethical principles. One way is to participate in workshops like Essential Ethics for Medical Communicators. I strongly urge every AMWA member to participate in this workshop to experience the process of learning how to handle ethical situations and to work with others in doing so.
Michael S. Altus, PhD, ELS, a Baltimore-based freelance medical writer and editor, is president of Intensive Care Communications, Inc. He wrote “AMWA Ethics FAQs” for AMWA.