Agreeing on what constitutes ethical principles in healthcare can be a lot easier than living them, said Dr. Stacey Rizza, Executive Medical Director for International Practice at the Mayo Clinic. The responsibility of living these ethical values is as important for healthcare organizations in advanced economies as it is in emerging markets. Mayo is a Founding Signatory to the Ethical Principles in Health Care (EPiHC) that IFC helped develop in 2019. EPiHC recently passed an important milestone of 100 signatories, a combination of healthcare providers, investors, insurers, and associations.
It seems obvious but yet, clearly ethical principles are not always a part of healthcare or else EPiHC wouldn’t be necessary. Why should healthcare businesses care?
With healthcare, ethics is foundational. You cannot provide equitable, quality healthcare without having ethics at the core. Part of our responsibility in giving care to people is doing it equitably and—just as importantly—producing outstanding outcomes. We believe that being ethically minded results both in equity and quality. The Mayo Clinic’s founders, the Mayo brothers, made a statement 150 years ago that guides us every day: the needs of the patient come first. We cannot meet the needs of our patients without ethics being interwoven into how we approach everything.
What do you think is the biggest challenge to embedding ethical principles in healthcare?
The biggest challenge is living the values. That is something we spend a lot of time working on. It may mean that we may do things a bit differently because one approach doesn’t fit with our values. The responsibility of any organization that wants to embed ethical principles in healthcare is to live the values in every area of its business. The other challenge is creating the infrastructure and innovation and quality to facilitate living those values.
How can we encourage other healthcare organizations to put ethical considerations at the core of their operations?
Ethics in healthcare should be embedded in every facet of an organization’s culture to ensure it becomes core to their operations. This means organizational leadership should model ethical behavior and continually encourage, inspire, and empower staff to follow suit. When ethical considerations are core to an organization’s operations, everyone benefits from improved quality, trust, and experience. This includes patients, collaborators and partners, and the greater community at large. For organizations who already embed ethics at the core of everything they do, they also characteristically serve as a role model for other organizations. This is one of the reasons Mayo Clinic chose to be a founding signatory of EPiHC. Not only does it foundationally represent what we believe as an organization, but it is an outward commitment clearly visible to other similar organizations.
How can we bring ethical principles to the forefront of medical education?
The best way to ensure ethical principles are at the forefront of medical education is to embed medical ethics directly into the educational curriculum. Students are our future healthcare leaders, and ensuring they are enthusiastic ambassadors for ethical healthcare is essential. This might mean highlighting specific organizations and initiatives—like EPiHC—to our learners early on in their education. Additionally, for healthcare organizations who teach or provide rotational opportunities for medical students, having educators who are role models for the ethical principles and behaviors discussed in the classroom is a necessity.
How much progress are you seeing globally when it comes to adoption of ethical principles?
It is becoming more relevant and people are becoming more aware of embedding ethics in how they do business, practice medicine, and present themselves as an organization. Once somebody is willing to commit to and follow ethical principles, it distinguishes them. I also believe that doing things ethically pays off in the end in terms of better quality of care and patient experiences.
What is the value of EPiHC?
By creating a community, EPiHC allows us to foster best practices and build a movement over time. Together, we can share our experiences, collaborate, and work through hardships or challenges we encounter.
This interview has been edited for length and clarity
Dr. Stacey Rizza is the Executive Medical Director for International Practice at Mayo Clinic. She is an Infectious Disease physician at Mayo Clinic in Rochester, Minnesota. Dr. Rizza has been involved in laboratory-based research, clinical research, educational initiatives, and has maintained a busy clinical practice. Dr. Rizza’s experience in international practice and academic initiatives provides a global perspective for healthcare collaborations. Dr. Rizza graduated with a degree in Biochemistry from Haverford College and received her Medical Degree from the Mayo Clinic Alix School of Medicine. She did an Internal Medicine Residency and Infectious Disease Fellowship at the Mayo Clinic School of Graduate Medical Education, followed by a Post-doctoral Fellowship in HIV and HCV Immunology at the University of California, San Francisco.