Global Health

What does it take to be an ethical global health manager? Numerous authors have weighed in on this topic, addressing the ethical development of managers both in general settings and in healthcare specifically.
In his 1988 classic The Moral Manager, Walton emphasizes the importance of “character” to a manager’s ethical development and ability to lead successfully. In doing so, he addresses one of the oldest questions in moral philosophy: “Can virtue be taught?” Ultimately, Walton (1988, 177) argues that it can: “Example, not exhortation and practice, not principle, take priority: carpenters become carpenters by building houses; pianists become pianists by playing the piano; managers become leaders by leading. The same is true of character: people become virtuous by practicing virtue and by living with moral mentors.”
Walton (1988, 219) summarizes many of his thoughts regarding the development of an ethical manager as follows:
Managers require virtue, an old-fashioned word with ongoing durability.
Not false pride but a sense of obligation drives executives to demand the best from themselves and, at least, the “better” from subordinates—a point requiring early and frequent statement in the organization’s philosophy and through reiteration of its code of ethics.
As character comes before charisma, so, too, does virtue come before versatility. To understand what virtue is and to live by what virtue demands are two related, but different, things.
Example is the best teacher, embodying those qualities that constitute virtue—prudence, fairness, fortitude, and temperance—enhances the manager’s teaching role.
Walton (1988, 219) also touches on the role of managers in a global economy, stating that “comprehension by executives of their own culture is a necessity, and appreciation of other cultures is a highly desirable auxiliary.”
Hartman (2015, 238) suggests that effective ethical decision making involves value judgments that result from the interaction of good character and appreciation of learned principles:
Your good character does not tell you exactly what to do in most complex situations, and certainly not in situations that, owing to radical changes in the environment, are unlike any you have seen before. It does demand that you make your significant decisions at the right time, in the right way, about the right things, with the right kind of involvement of the right people and for the right purposes. If you have only rules and habits to go by, you will be unable to come to any kind of useful understanding with people who have different rules. If you are not guided by a clear sense of what is important, you will make irrational decisions, and you will be a terrible leader.
The literature of global health management has sought to define ethics in the terms of global health. Pinto and Upshur’s (2013, 27) An Introduction to Global Health Ethics, referencing the work of Benatar, Daar, and Singer (2011), lists seven values to serve as the basis for global health ethics:
Respect for all human life
Human rights, responsibilities (duties) and needs—broadly considered
Equity
Freedom (freedom from “want,” as well as freedom “to do”)
Democracy (in a participatory sense)
Environmental ethics
Solidarity
The authors also offer a framework for transformational approaches (Pinto and Upshur 2013, 27):
Developing a global state of mind
Promoting long-term self-interest
Striking a balance between optimism and pessimism
Developing capacity (to be independent)
Achieving widespread access to public goods