This article presents a study on the ethical dilemma of whistleblowing in physical therapy, and suggests some lines for further research on this topic as well as ways for integrating it in the physical therapy curriculum. The study examines the self-reported willingness of physical therapy students to report misconduct, whether internally or externally, to protect the patient's interests. Internal disclosure entails reporting the wrongdoing to an authority within the organisation. External disclosure entails reporting the offence to an outside agency, such (...) as the police, professional organisation, or press. The findings indicate that the students view the acts that are detrimental or cause injustice to the patient in a very serious light. In dilemma situations such as these, the students reported a willingness to act. The students also report considerably greater likelihood of whistleblowing internally than externally. The pattern reveals a desire to correct the misconduct coupled with a marked decline in the willingness to blow the whistle as this act moved from the workplace to an external authority. (shrink)

Although medical centres have established boards, special committees, and offices for the review and redress of breaches in ethical behaviour, these mechanisms repeatedly prove themselves ineffective in addressing research misconduct within the institutions of academic medicine. As the authors see it, institutional design: systematically ignores serious ethical problems, makes whistleblowers into institutional enemies and punishes them, and thereby fails to provide an ethical environment.The authors present and discuss cases of academic medicine failing to address unethical behaviour in academic science and, (...) thereby, illustrate the scope and seriousness of the problem. The Olivieri/Apotex affair is just another instance of academic medicine’s dereliction in a case of scientific fraud and misconduct. Instead of vigorously supporting their faculty member in her efforts to honestly communicate her findings and to protect patients from the risks associated with the use of the study drug, the University of Toronto collaborated with the Apotex company’s “stalling tactics,” closed down Dr Olivieri’s laboratory, harassed her, and ultimately dismissed her.The authors argue that the incentives for addressing problematic behaviour have to be revised in order to effect a change in the current pattern of response that occurs in academic medicine. An externally imposed realignment of incentives could convert the perception of the whistleblower, from their present caste as the enemy within, into a new position, as valued friend of the institution. The authors explain how such a correction could encourage appropriate reactions to scientific misconduct from academic medicine. (shrink)

Background The case of Margaret Haywood, the ‘undercover nurse’, is a significant one for the UK's National Health Service (NHS). She investigated complaints made about the Royal Sussex County Hospital and covertly filmed inpatients experiencing care detrimental to their health. The material was subsequently broadcast on the BBC's Panorama programme. It caused a scandal and brought about changes at the hospital, as well a demand for greater clinical leadership. Margaret Haywood was, however, struck off the nursing register for breaching confidentiality (...) and because of the methods she used to blow the whistle. Methods The authors apply the ethical lenses of purpose, principle, people and power to explore this case. Results This is a morally ambiguous situation in which both the protagonist and the organisation compromised their core values. The undercover nurse used individuals as a means to a ‘higher’ end, and the Brighton and Sussex University Hospitals NHS Trust are seen to have deviated from the ethical to the business map, in a contradiction of what the health service represents. Conclusions These deficits can be repaired by reinforcement of the ethics of duty and ideals on a practical level and the involvement of clinicians to lead at a management level, to act as a moral compass. (shrink)