All of the scenarios in the policy suit should be considered from the perspective of a health professional in a staff appointment as the lead officer for medical policy within a Ministry of Defence (rank equivalent of OF4/Commander/Lieutenant Colonel/Wing Commander).

Step 1 – IDENTIFY THE PROBLEM(S)

• Briefly state the Scenario: You have written performance reports on your subordinates. Your superior officer seems to be showing favoritism in their reports on a specific group of your people. What do you do?
• List the Issues that arise from the scenario.
• Identify Critical Information required and Assumptions to be made:

This scenario covers the ethics and law regarding behaviour towards subordinates your role in holding your superiors to account for their actions. This topic is likely to be covered under Human Resources (HR) policies for equality, diversity and inclusion (EDI) and to avoid discrimination. It covers similar issues to the scenario POLICY FOUR.

Step 2 – ANALYSE

Patient: whilst this does not involve patients, you may need to consider the impact of this complaint on any patient-facing duties that your personnel may have.

Clinical: you are might also need to consider if this discrimination has any impact on clinical services.

Legal: you and your superior officer will be obliged to follow the HR procedures of your organisation in regard to the application of EDI policies within the reporting system. Para 30 of the WMA International Code of Medical Ethics states: The physician must engage with other physicians, health professionals and other personnel in a respectful and collaborative manner without bias, harassment, or discriminatory conduct. The physician must also ensure that ethical principles are upheld when working in teams.

Societal/Military: it is also important from a leadership perspective that your subordinates feel that their performance is being fairly assessed without discrimination.

Step 3 – FUSE

• Summarise conclusions
• Insert citations to key reference sources for your analysis
• Determine the exact Decision(s) to be made

This scenario covers the legal and ethics dimensions of inter-personal relations between employees. You clearly have a duty on behalf of your subordinates to ensure that the reporting system is fair and non-discriminatory. This scenario is most likely to occur in healthcare on the basis of gender, sexual orientation or professional loyal (between doctors and everyone else!)   

Step 4 – DECIDE

• What is your Decision?
• Why (can you justify it)?
• Residual uncertainly, need for review?

You must comply with the HR processes of your organisation. You should raise the issue with your superior officer to understand if your suspicion of favouritism is true, but it will be a delicate topic that will have to be raised carefully. You will need to decide if you need to escalate your concerns if you do not receive a satisfactory answer.  

Contributor – Air Vice Marshal (Rtd) Alastair Reid CB FFOM, Surgeon General UK Defence Medical Services 2019-2021.