The healthcare sector has constantly grappled with ethical questions at the cutting edge of regulation. This is often the case in the field of bioethics—the study of and response to the moral and ethical questions arising from the research, development, sale, and clinical use of pharmaceutical and healthcare products and associated technologies. How far should we go to save someone’s life? Is it fair to experiment on certain groups of people? Established principles and rules on bioethics (e.g., autonomy, beneficence, informed consent), together with a growing body of industry guidelines, have helped companies to navigate these questions.
However, the exponential speed of research and biotechnology development presents healthcare companies with ever more complex ethical questions. This challenge has been amplified by the convergence between healthcare and data, technology, as well as growing public scrutiny of the corporate response to the COVID-19 pandemic.
To effectively identify and manage arising issues, companies need robust policies, governance structures and risk management processes—as well as a strong organizational culture.
A human rights-based approach provides a strong foundation for addressing ethical issues. Drawing on BSR’s work with healthcare and tech companies, and our expertise in applying human rights frameworks to businesses’ ethical challenges, this blog shares some insights on best practices for managing emerging ethical issues in a corporate context.
The Challenge of Uncertainty
What do we mean by emerging ethical issues? This could be any decision or activity that raises new ethical questions of “right and wrong” and challenges a company to define “what kind of company are we?” Are we comfortable enabling an elderly person’s loved ones to always track their location? Should we pursue a marketing strategy even if it excludes certain people?
Such emerging ethical issues have common characteristics: the actual or potential impacts are not well or fully understood, and regulation and existing policies don’t provide all the answers. The public may not even know yet where it stands, as we’ve seen recently on the question of vaccinating children against COVID-19 or deploying facial recognition in public spaces. Caught between the precautionary principle (“stop until we know it’s safe”) and the pressure to innovate—and with limited time to decide in the face of exponential change—companies must find a way to navigate ethical uncertainty.
Lead with “Tone from the Top” and Inspire “Bottom-Up” Engagement
Leadership is essential to set a company’s ambition beyond legal compliance and drive required action. But this is most effective when combined with the engagement of employees, who will need to identify and address emerging ethical issues on a day-to-day basis. We’ve seen the positive impact of CEOs addressing employees directly and honestly on a company’s challenges and building employees’ ethical “muscle” memory via internal “ambassador” networks and informal group discussions on ethical topics.
Healthcare companies—and other companies adopting mission-driven purposes—have the advantage that their employees and leaders tend to be motivated by the company’s societal mission and thus predisposed to engaging on emerging ethical issues. Seize it.
Adopt a Cross-Functional Approach
Emerging ethical issues, especially where healthcare and tech are concerned, do not fit neatly within the defined lines of corporate functions. A new medical device may raise questions about data ethics, public policy around access to healthcare, and end-of-life disposal. A cross-functional approach is required to ensure companies approach emerging ethical issues in an informed way that benefits from multiple perspectives.
Leading healthcare and tech companies do this well by convening a range of expert voices on their external bioethics advisory committees (including philosophers, theologists, and sociologists) or organizing internal working groups that bring together different functions (e.g., compliance, privacy, research and development, human rights) to identify and discuss appropriate responses to potential emerging ethical issues across the business.
Anchor in Enterprise Risk Frameworks
Companies should consider their “ethics and compliance” risks in a proactive and future-looking way and include emerging ethical issues (that may not yet present legal or compliance risks) into their enterprise risk management (ERM) frameworks. Although we are seeing progress toward ERM frameworks integrating “ethical” risks to people and the planet beyond legal compliance risks, there is still a ways to go.
In practice, anchoring responsibility for emerging ethical issues in business ethics and compliance functions can enable greater reach and impact across the company by leveraging the established relationships, governance structures, and engagement resources of these risk management functions. A strong and strategically minded ethics and compliance function can also help raise awareness around emerging ethical issues at executive and board levels.
Be Open and Engage External Perspectives
Transparency and open engagement with external experts and stakeholders lead to more informed and accountable positions that avoid groupthink. Advisory boards with external experts are a common feature of healthcare companies and have inspired the development of digital ethics boards in tech companies. It is important to bring independent expertise and external perspectives into a company’s decision-making process, which can also be achieved through ad hoc bilateral engagement with experts and/or through industry and multistakeholder collaborations.
A recent BSR project revealed that healthcare companies don’t talk about their bioethics challenges externally in the open way we’ve increasingly seen on other environmental and social topics. Tech companies have learned the hard way and are now showing signs of greater transparency regarding what dilemmas they face and how they are resolving them. Healthcare and other companies would do well not to wait for a similar crisis in trust to pivot to a more open culture—as the COVID-19 response has prompted some to do already.
To maximize the benefits of healthcare and new technologies for society, companies will need strong governance structures and organizational culture to identify and address emerging ethical dilemmas as they arise. The insights in this blog should help build a more resilient business in today’s rapidly changing context, as well as meet growing regulatory and stakeholder expectations on managing social and environmental impacts.