As amended by the Board of Governors Dec. 5, 2023
Preamble
The purpose of the Code of Ethics of the American College of Healthcare Executives is to serve as a standard of conduct for members. It contains standards of ethical behavior for healthcare executives in their professional relationships. These relationships include colleagues, patients or others served; members of the healthcare executive’s organization and other organizations; the community; and society as a whole.
The Code of Ethics also incorporates standards of ethical behavior governing individual behavior, particularly when that conduct directly relates to the role and identity of the healthcare executive.
The fundamental objectives of the healthcare leadership profession are to maintain or enhance the overall quality of life, dignity and well-being of every individual needing healthcare service, and to create an equitable, accessible, effective, safe and efficient healthcare system.
Healthcare executives have an obligation to act in ways that will merit the trust, confidence and respect of healthcare professionals, staff and the general public. Therefore, healthcare executives should lead lives that embody an exemplary system of values and ethics.
In fulfilling their commitments and obligations to patients and others served, healthcare executives function as moral advocates and models. Since every leadership decision affects the health and well-being of both individuals and communities, healthcare executives must carefully evaluate the possible outcomes of their decisions. In organizations that deliver health services, they must work to safeguard and foster the rights, interests and prerogatives of all patients and others served.
The role of moral advocate requires that healthcare executives take actions necessary to promote such rights, interests and prerogatives. Paying attention to the potential disparities of care that exist in their community is a fundamental part of their leadership role.
Being a model means that decisions and actions will reflect personal integrity and ethical leadership that others will seek to emulate.
I. The Healthcare Executive’s Responsibilities to the Profession of Healthcare Leadership
The healthcare executive shall:
A. Uphold the Code of Ethics, mission and values of the American College of Healthcare Executives.
B. professional activities with honesty, integrity, respect, equity, fairness and good faith in a manner that will reflect well upon the profession.
C. Comply with all laws and regulations pertaining to healthcare leadership in the jurisdictions in which the healthcare executive is located or conducts professional activities.
D. Maintain competence and proficiency in healthcare leadership by implementing a personal program of assessment and continuing professional education.
E. Never intentionally exploit professional relationships for personal gain.
F. Disclose—and when required or determined by a board review of the executives’ disclosure, avoid—financial and other conflicts of interest.
G. Use this Code to further the interests of the profession and not for self-serving reasons.
H. Respect professional confidences and protect sensitive information and communications.
I. Enhance the dignity and image of the healthcare leadership profession through positive public information programs.
J. Refrain from participating in any activity that demeans the credibility and dignity of the healthcare leadership profession.
K. Address situations in which they believe a healthcare executive is not adhering to the Code of Ethics.
II. The Healthcare Executive’s Responsibilities to Patients or Others Served
The healthcare executive shall, within the scope of his or her authority:
A. Work to ensure the existence of a culture of respect, equity and dignity.
B. Build trust with all patients and their families, as well as with all members of the community.
C. Work to ensure the existence of a process to evaluate the safety, value, quality and equity of care or service rendered.
D. Work to ensure fair and equitable processes pertaining to patients’ financial matters.
E. Work to establish safeguards that will not allow discriminatory organizational practices to exist.
F. Work to ensure the care team is representative of the patients and communities it serves, which can help improve health outcomes.
G. Work to ensure the existence of a process that will advise patients and others served clearly and truthfully of the rights, opportunities, responsibilities and risks regarding available health services.
H. Work to ensure there is a process in place to facilitate the resolution of conflicts that may arise when the personal values of patients and their families differ from those of employees and other providers of care.
I. Demonstrate zero tolerance for any abuse of power that compromises patients and others served.
J. Work to provide a process that ensures the autonomy and self-determination of patients and others served.
K. Work to ensure the existence of procedures that will safeguard the confidentiality and privacy of patients and others served.
L. Work to ensure the existence of an ongoing process and procedures to review, develop and consistently implement evidence-based clinical practices throughout the organization.
III. The Healthcare Executive’s Responsibilities to the Organization
The healthcare executive shall, within the scope of his or her authority:
A. Lead the organization in prioritizing patient care above other considerations.
B. Provide healthcare services consistent with available resources and, when there are limited resources, work to ensure the existence of a resource allocation process that reflects the ethical considerations of fairness, equity and transparency.
C. Conduct both competitive and cooperative activities in ways that improve community health services.
D. Lead the organization in the use and improvement of standards of management, ethical leadership and sound business practices.
E. Respect the customs, beliefs and practices of patients or others served, consistent with the organization’s philosophy.
F. Be truthful in all forms of professional and organizational communication, and not disseminate information that is false, misleading or deceptive.
G. Report negative financial and other information promptly and accurately, and initiate appropriate action.
H. Prevent fraud, abuse and aggressive accounting practices that may result in disputable and/or inaccurate financial reports.
I. Create an organizational environment in which both clinical and leadership mistakes are minimized and, when they do occur, are disclosed and addressed effectively.
J. Work to ensure that the organization complies with all applicable laws and regulations.
K. Work with local, regional, statewide and federal organizations to ensure adequate response to identified public health emergencies, including appropriate pre-planning and exercises of such plans.
L. Implement an organizational code of ethics, including conflict of interest principles and whistleblower protections, and monitor compliance.
M. Ensure that competent and effective ethics resources and mechanisms are available for staff, patients and families to address organizational and clinical ethics issues.
IV. The Healthcare Executive’s Responsibilities to Employees
Healthcare executives have ethical and professional obligations to the employees they manage that encompass but are not limited to:
A. Creating a work environment that promotes ethical and equitable conduct.
B. Providing a work environment that encourages free expression of ethical concerns and provides effective mechanisms for discussing and addressing such concerns.
C. Promoting a healthy work environment, which includes freedom from harassment—sexual or otherwise—and coercion of any kind, especially to perform illegal or unethical acts.
D. Ensuring a culture of inclusivity that seeks to prevent discrimination on the basis of race, ethnicity, religion, gender, sexual orientation, age and disability.
E. Promoting a clinical environment that intends to avoid discriminating behavior toward healthcare professionals and trainees from patients and families.
F. Working to ensure there is a process in place to facilitate the resolution of conflicts that may arise between workforce members or the individual and the organization.
G. Providing a work environment that promotes the proper use of employees’ knowledge and skills.
H. Providing a safe, healthy and equitable work environment.
I. Ensuring clinicians and other staff are not subject to violence or any form of preventable harm by patients, family members or visitors.
J. Promoting a culture in which employees are provided fair compensation and benefits based upon the work they perform.
V. The Healthcare Executive’s Responsibilities to Community and Society
The healthcare executive shall:
A. Work in partnership with other local organizations to meet the needs of the community.
B. Work to identify and seek opportunities to foster health promotion in the community.
C. Encourage and participate in public dialogue on healthcare policy issues, and advocate for solutions that will promote quality healthcare and improve the health status of the community and access to care.
D. Demonstrate and promote an understanding of the social determinants of health and encourage initiatives to address factors influencing them, such as education, housing, employment and similar issues affecting health, functioning, and quality-of-life outcomes and risks, while applying short- and long-term assessments to leadership decisions affecting both community and society.
E. Provide prospective patients and others with adequate and accurate information, enabling them to make informed decisions regarding services and their costs.
F. Work to support access to healthcare services to all people, particularly the underserved and disenfranchised.
VI. The Healthcare Executive’s Responsibility to Report Violations of the Code
A member of ACHE who has reasonable grounds to believe that another member has violated this Code has a duty to communicate such facts to the ACHE Ethics Committee.
Additional Resources
Available on ache.org, by emailing ethics@ache.org, or by calling ACHE at (312) 424-2800.
1. ACHE Ethical Policy Statements"Considerations for Healthcare Executive-Supplier Interactions"
"Creating an Ethical Culture Within the Healthcare Organization"
"Decisions Near the End of Life"
"Ethical Decision Making for Healthcare Executives"
"Ethical Issues Related to a Reduction in Force"
"Ethical Issues Related to Staff Shortages"
"Health Information Confidentiality"
"Impaired Healthcare Executives"
"Promise Making, Keeping and Rescinding"
3. ACHE Ethics Committee Scope and Function