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National Center for Ethics in Health Care


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Ethical Leadership



Fostering an Ethical Environment and Culture

Leaders strongly influence the ethical environment and culture of health care organizations, which, in turn, influence employee behavior. The Ethical Leadership component of IntegratedEthics® (IE) provides health care leaders with the practical tools and training they need to foster an ethical environment and culture that will make it easier for employees to "do the right thing."

The IntegratedEthics model of ethical leadership is organized around four compass points:

1. Demonstrate that ethics is a priority

2. Communicate clear expectations for ethical practice

3. Practice ethical decision making

4. Support your local ethics program 

Are you looking for tools to positively influence ethical practices in your organization? Check out the IE Ethical Leadership Tools Guide.


Ethical Leadership: Fostering an Ethical Environment and Culture - The primer explains the role leaders play in creating and sustaining an ethical culture in health care organizations, critical factors for success, and the specific behaviors leaders use to foster an ethical environment and culture. Intended for health care leaders at the executive and mid-manager levels.

Perceptions of Ethical Leadership and the Ethical Environment and Culture: IntegratedEthics Staff Survey Data from the VA Health Care System. AJOB Primary Research, 2013. 4(1) 44-58.

Ethics Quality Helps Build Healthy Organizations. Organizational Health, 19 (Summer 2013).

IntegratedEthics Policy - VHA Handbook 1004.06



Ethical Leadership: Fostering an Ethical Environment and Culture Video - 44-minute, interactive training video to teach viewers leadership behaviors that will help foster an ethical leadership and culture. 


Tools to explain the role of the Ethical Leadership Coordinator:

Instructions for the Ethical Leadership Coordinator  

Triage Tool for Ethics-Related Leadership Decisions - a tool to help leaders identify helpful resources and best approaches for an ethics-related decision (Triage Tool instructions



IE Program: Status Check and Planning Tool - two-page tool to assist in assessing IE Program performance and identifying areas that need improvement

Tools to support the development of ethical leadership skills:

Ethical Leadership Bookmark 2in x 8in3in x 5in 

Ethical Decision-making Quality Check 

Ethical Leadership Self-Assessment Tool (ELSA) 

EL Interview Questions Tool - Behavior-based interview questions for HPDM level 2-4 leadership candidates, corresponding to the Four Compass Points of Ethical Leadership

Peer Feedback Activity on Leadership Behaviors and the Organization's Ethical Environment - based on the ELSA, this 15-minute group activity allows leaders to obtain information from their peers on behaviors that have had positive and negative effects on their organization's ethical environment and culture

Value of the Month Ethical Leadership Activities - a set of brief discussion activities that include value and discussion prompts, examples, and case studies. Intended for leaders at all levels, including committee chairs, to help employees articulate their individual values and improve mutual understanding of how values impact the work of the group or committee (editable version

Value of the Day Discussion - a week-long series based on the Value of the Month activity 

Value of the Day E-mail Activity - e-mail activity based on the Value of the Day Discussion

Journal Activity: Ethical Fading - This journal activity provides a venue for reflection, discussion, and inquiry about the concept of ethical fading and its antidote, leading truthfully.

Planning Guide
Participant Guide

Journal Activity: Managing to Be Ethical - This journal activity provides a venue for reflection, discussion and inquiry about the practice of ethical leadership in an organization.

Planning Guide
Participant Guide

Ethical Leadership Tools Guide - designed to provide practical tools to positively influence ethical practices in your organization. The tools have varying time commitments ranging from a few minutes to several hours and are suitable for a variety of forums, including leadership and management meetings, committee discussions, facility emails, and personal use, and are listed based on the desired ethical practice you wish to promote.

Ethical Leadership Curriculum (Faculty Guide) - based on the ethical leadership compass, this training curriculum is intended to help leaders develop new skills and behaviors consistent with ethical leadership. Includes slides, activities, and handouts for facilitators and participants.

Ethical Leadership: Quick Activities - a series of 15-minute activities that can be used to highlight and practice strong ethical leadership behaviors over a series of leadership meetings 

      Compass Point One: Demonstrating That Ethics Is a Priority

      Compass Point Two: Communicating Clear Expectations for Ethical Practice

Talk About Ethics - an activity and activity guide for all staff members to help them consider how they "talk about ethics" and to encourage discussion with their colleagues

Ethics Discussion Activities - using journal articles and media examples, activities prompt group discussion of ethical leadership concepts

Tear Sheets on Ethical Leadership from IntegratedEthics in Action – Articles highlight decisions, processes, and activities to help leaders of health care organizations foster an ethical environment and culture. Tear sheets can be used as educational emails, reprints in local or facility newsletters, or discussion topics for meetings.

Tools to improve plans to strengthen an organization's environment and culture:

Ethical Leadership Improvement Plan Checklist - two-page checklist to guide design and implementation of strong EL improvement projects

Ethical Leadership Improvement Plan Summary - two-page worksheet to capture a concise snapshot of a completed EL improvement plan 

Guidance for Strong Ethical Leadership Projects

Ethical leadership tips to support psychological safety:

Values-Based Meeting Ground Rules 

Employee Ethics Tip Sheet - Provides practical suggestions for how employees can support ethics and integrity in VA, and resources to help employees resolve ethics questions. Fillable format allows facilities to customize with local ethics contact information.

Employee Ethics Tip Poster - 11" x 17" size. Fillable format allows facilities to customize with local ethics contact information.

Ethical Leadership Tips - Double-sided tips sheet to provide leaders quick and practical information about the Four Compass Points of Ethical Leadership. Included are examples, phrases, and discussion starters that leaders may incorporate into their daily work to enhance the ethical environment and culture in their facility or program office. (*Note that the document has been formatted to allow for double sided printing.)


IE Archive: Materials used in initial launch of VA IE program