WEBVTT 1 00:00:00.990 --> 00:00:01.860 Hi, everyone, 2 00:00:01.860 --> 00:00:03.240 and welcome to this week's lecture 3 00:00:03.240 --> 00:00:05.463 about managerial ethics in global health. 4 00:00:06.780 --> 00:00:08.370 In this week's lecture, 5 00:00:08.370 --> 00:00:10.350 we're going to go over some topics 6 00:00:10.350 --> 00:00:12.210 related to managerial ethics, 7 00:00:12.210 --> 00:00:13.650 including the importance of ethics 8 00:00:13.650 --> 00:00:16.080 in managerial decision-making 9 00:00:16.080 --> 00:00:19.440 and the additional sensitivity of ethical decision-making 10 00:00:19.440 --> 00:00:22.413 in situations where two or more cultures come together. 11 00:00:23.520 --> 00:00:24.353 In this chapter, 12 00:00:24.353 --> 00:00:26.280 we're going to learn how to analyze problems, 13 00:00:26.280 --> 00:00:29.130 promote solutions, and encourage decision-making, 14 00:00:29.130 --> 00:00:30.750 exercise cultural sensitivity 15 00:00:30.750 --> 00:00:32.823 in internal and external communications, 16 00:00:33.750 --> 00:00:35.910 and advocate for the rights and responsibilities 17 00:00:35.910 --> 00:00:38.823 of patients and their families, among other things. 18 00:00:40.920 --> 00:00:44.100 So to begin with, the Code of Ethics 19 00:00:44.100 --> 00:00:46.350 of the American College of Healthcare Executives 20 00:00:46.350 --> 00:00:48.120 speaks of a manager's responsibilities 21 00:00:48.120 --> 00:00:51.960 to four distinct constituencies: 22 00:00:51.960 --> 00:00:56.940 the organization, employees, patients or others served, 23 00:00:56.940 --> 00:00:59.190 and the community and society. 24 00:00:59.190 --> 00:01:00.660 While it's challenging 25 00:01:00.660 --> 00:01:03.750 to manage all of these responsibilities 26 00:01:03.750 --> 00:01:06.150 in a single nature or culture, 27 00:01:06.150 --> 00:01:08.178 it's even more challenging 28 00:01:08.178 --> 00:01:11.250 when the manager's scope traverses national boundaries 29 00:01:11.250 --> 00:01:12.330 and diverse cultures, 30 00:01:12.330 --> 00:01:15.933 such as in the international leadership context. 31 00:01:18.000 --> 00:01:21.810 Because of that, we'll talk about some different topics 32 00:01:21.810 --> 00:01:25.830 within the ethical conduct in organization, 33 00:01:25.830 --> 00:01:27.210 including managerial ethics, 34 00:01:27.210 --> 00:01:29.730 professional ethics, and bioethics. 35 00:01:29.730 --> 00:01:33.420 So to begin with, the study of managerial ethics seeks 36 00:01:33.420 --> 00:01:35.190 to answer questions of what a manager should do 37 00:01:35.190 --> 00:01:37.290 when confronted with ethical issues 38 00:01:37.290 --> 00:01:40.140 related to managerial responsibilities. 39 00:01:40.140 --> 00:01:42.240 Ethical management requires managers 40 00:01:42.240 --> 00:01:44.040 to develop an orientation 41 00:01:44.040 --> 00:01:46.050 that goes beyond their individual self-interest 42 00:01:46.050 --> 00:01:48.360 and leads to a recognition of a moral responsibility 43 00:01:48.360 --> 00:01:50.510 to the organization and its constituencies. 44 00:01:52.376 --> 00:01:54.690 Organizations operating on a global basis 45 00:01:54.690 --> 00:01:56.700 often face particularly tough 46 00:01:56.700 --> 00:01:58.200 or difficult ethical challenges 47 00:01:58.200 --> 00:02:01.410 because of different cultural and market forces 48 00:02:01.410 --> 00:02:02.660 that are exerted on them. 49 00:02:03.600 --> 00:02:05.820 National boundaries and varying cultural traditions 50 00:02:05.820 --> 00:02:07.350 are accepted as part of the landscape 51 00:02:07.350 --> 00:02:09.660 within which global health managers function. 52 00:02:09.660 --> 00:02:12.810 And globalization is arguably leading to greater uniformity 53 00:02:12.810 --> 00:02:15.063 in many dimensions of civilization. 54 00:02:16.980 --> 00:02:20.310 In addition, it's important to understand 55 00:02:20.310 --> 00:02:22.470 professional ethics and bioethics 56 00:02:22.470 --> 00:02:24.120 as they both apply to the supervision 57 00:02:24.120 --> 00:02:27.150 of professional individuals in the delivery of healthcare. 58 00:02:27.150 --> 00:02:30.120 The concerns of bioethics grow out of the day-to-day issues 59 00:02:30.120 --> 00:02:32.310 facing healthcare professionals in the delivery 60 00:02:32.310 --> 00:02:34.740 of clinical and research services. 61 00:02:34.740 --> 00:02:36.540 Even if the healthcare manager themself 62 00:02:36.540 --> 00:02:38.610 does not have a clinical background, 63 00:02:38.610 --> 00:02:41.400 their supervisory responsibility for physicians, nurses, 64 00:02:41.400 --> 00:02:42.780 and other professional practitioners 65 00:02:42.780 --> 00:02:45.570 requires an appreciation for the issues they face 66 00:02:45.570 --> 00:02:47.730 in patient care and research. 67 00:02:47.730 --> 00:02:49.650 This responsibility becomes more complex 68 00:02:49.650 --> 00:02:51.060 in a global context, 69 00:02:51.060 --> 00:02:53.250 especially if the manager and professional practitioners 70 00:02:53.250 --> 00:02:55.920 that cultural orientations different from one another 71 00:02:55.920 --> 00:02:57.393 or of their patients. 72 00:02:58.620 --> 00:02:59.820 For that reason, 73 00:02:59.820 --> 00:03:02.550 it's important to avoid cultural imperialism 74 00:03:02.550 --> 00:03:04.380 and moral relativism. 75 00:03:04.380 --> 00:03:06.450 Cultural imperialism refers to the practice 76 00:03:06.450 --> 00:03:08.640 of imposing a society's own culture 77 00:03:08.640 --> 00:03:10.950 and morality on people of another society, 78 00:03:10.950 --> 00:03:13.710 while moral relativism speaks to the tendency 79 00:03:13.710 --> 00:03:16.440 to consider morality relative to one's own society, 80 00:03:16.440 --> 00:03:17.970 potentially leading to assumptions 81 00:03:17.970 --> 00:03:20.010 that the ethical beliefs of people in another society 82 00:03:20.010 --> 00:03:22.683 are appropriate for them without question. 83 00:03:25.080 --> 00:03:28.440 One way that healthcare managers can help to navigate 84 00:03:28.440 --> 00:03:32.010 these complex ethical challenges in different settings 85 00:03:32.010 --> 00:03:34.113 is the formation of ethics committees. 86 00:03:35.130 --> 00:03:36.660 Many organizations throughout the world 87 00:03:36.660 --> 00:03:38.070 have these ethics committees, 88 00:03:38.070 --> 00:03:39.630 which help to address ethical issues 89 00:03:39.630 --> 00:03:41.970 and meet accreditation standards. 90 00:03:41.970 --> 00:03:43.350 When such committees are used to aid 91 00:03:43.350 --> 00:03:45.150 in the management of a healthcare organization, 92 00:03:45.150 --> 00:03:48.063 particular attention must be paid to their makeup. 93 00:03:50.400 --> 00:03:51.870 In the healthcare delivery setting, 94 00:03:51.870 --> 00:03:54.600 ethics committee would be expected to comprise both managers 95 00:03:54.600 --> 00:03:56.430 and clinical practitioners responsible 96 00:03:56.430 --> 00:03:57.990 for delivering patient care, 97 00:03:57.990 --> 00:03:59.520 as well as external participants 98 00:03:59.520 --> 00:04:02.580 with advanced training in law, ethics, and medicine. 99 00:04:02.580 --> 00:04:04.920 The selection of qualified and interested individuals 100 00:04:04.920 --> 00:04:07.740 to serve on the committee and present diverse perspectives 101 00:04:07.740 --> 00:04:08.910 can have a significant impact 102 00:04:08.910 --> 00:04:11.160 on the organization's ethical climate. 103 00:04:11.160 --> 00:04:12.420 Later in this chapter, we'll divert, 104 00:04:12.420 --> 00:04:13.560 we'll discuss the importance 105 00:04:13.560 --> 00:04:16.383 of what these diverse perspectives include. 106 00:04:17.610 --> 00:04:21.330 Some examples of diversity are demographic diversity, 107 00:04:21.330 --> 00:04:25.787 religious diversity, socioeconomic diversity, 108 00:04:25.787 --> 00:04:27.513 and linguistic diversity. 109 00:04:28.500 --> 00:04:29.970 Particular attention should be paid 110 00:04:29.970 --> 00:04:31.230 to the educational preparation 111 00:04:31.230 --> 00:04:32.250 that committee members receive 112 00:04:32.250 --> 00:04:34.020 prior to initiating their responsibilities 113 00:04:34.020 --> 00:04:35.223 to the organization. 114 00:04:37.860 --> 00:04:42.860 So next, when we talk about the the creation 115 00:04:43.950 --> 00:04:45.510 of these ethics committees 116 00:04:45.510 --> 00:04:49.500 and the formation of an ethical manager 117 00:04:49.500 --> 00:04:52.020 or ethical leader of a healthcare organization, 118 00:04:52.020 --> 00:04:54.630 there's a few key steps or a few key elements 119 00:04:54.630 --> 00:04:57.543 that play a role in developing their right perspective. 120 00:04:59.310 --> 00:05:02.400 Some are depicted on the slide. 121 00:05:02.400 --> 00:05:06.705 Others include not having false pride, 122 00:05:06.705 --> 00:05:09.090 but rather a sense of obligation that drives executives 123 00:05:09.090 --> 00:05:11.130 to demand the best from themselves 124 00:05:11.130 --> 00:05:13.143 and the best from subordinates. 125 00:05:15.150 --> 00:05:17.880 Virtue is also very important. 126 00:05:17.880 --> 00:05:22.680 And scholars write that to understand what virtue is 127 00:05:22.680 --> 00:05:25.470 and to live by what virtue demands are too related, 128 00:05:25.470 --> 00:05:26.823 but different things. 129 00:05:28.170 --> 00:05:31.350 And it's important for managers 130 00:05:31.350 --> 00:05:32.820 to understand the comprehension 131 00:05:32.820 --> 00:05:36.150 by executives of their own culture is a necessity. 132 00:05:36.150 --> 00:05:37.860 And appreciation of other cultures 133 00:05:37.860 --> 00:05:39.993 is a highly desirable skill as well. 134 00:05:41.790 --> 00:05:44.790 Some other skills and competencies 135 00:05:44.790 --> 00:05:48.120 are related to the understanding of human rights, 136 00:05:48.120 --> 00:05:49.500 which include, but are not limited to, 137 00:05:49.500 --> 00:05:51.930 the respect for all human life, 138 00:05:51.930 --> 00:05:53.250 the understanding of human rights, 139 00:05:53.250 --> 00:05:55.290 responsibilities, and needs, 140 00:05:55.290 --> 00:05:59.738 equity, freedom, participatory democracy, 141 00:05:59.738 --> 00:06:02.403 environmental ethics, and solidarity. 142 00:06:04.470 --> 00:06:06.510 So now let's turn to some ethical theories 143 00:06:06.510 --> 00:06:07.860 that a manager might use 144 00:06:07.860 --> 00:06:12.690 in order to drive their decision-making. 145 00:06:12.690 --> 00:06:15.756 The first that we'll talk about is consequentialism. 146 00:06:15.756 --> 00:06:18.090 Consequentialism represents a group of ethical theories 147 00:06:18.090 --> 00:06:19.860 that seek to evaluate an action 148 00:06:19.860 --> 00:06:23.820 as ethical or unethical based on the actions consequences. 149 00:06:23.820 --> 00:06:26.100 One of the most prominent of consequentialist theories 150 00:06:26.100 --> 00:06:27.690 is utilitarian ethics, 151 00:06:27.690 --> 00:06:31.140 which is based on the following principles: 152 00:06:31.140 --> 00:06:32.640 The principle of consequences, 153 00:06:32.640 --> 00:06:34.650 which states that no action is morally right 154 00:06:34.650 --> 00:06:36.840 or morally wrong in itself. 155 00:06:36.840 --> 00:06:38.400 The principle of utility. 156 00:06:38.400 --> 00:06:40.410 The more good consequences an act produces, 157 00:06:40.410 --> 00:06:42.990 the better or more right that act is. 158 00:06:42.990 --> 00:06:44.760 The principle of hedonism. 159 00:06:44.760 --> 00:06:47.100 Good consequences are those that maximize pleasure 160 00:06:47.100 --> 00:06:48.303 and minimize pain. 161 00:06:49.260 --> 00:06:50.820 And the social principle, 162 00:06:50.820 --> 00:06:52.070 which states that the best action 163 00:06:52.070 --> 00:06:54.720 is the one that leads to the highest level of happiness 164 00:06:54.720 --> 00:06:56.820 for the largest possible number of people. 165 00:06:57.660 --> 00:06:59.580 At times, consequentialism in global health 166 00:06:59.580 --> 00:07:01.440 can be counterproductive. 167 00:07:01.440 --> 00:07:03.000 Many people are uncomfortable with the idea 168 00:07:03.000 --> 00:07:04.590 that the end justifies the means. 169 00:07:04.590 --> 00:07:06.900 And they feel that some actions 170 00:07:06.900 --> 00:07:09.600 that might be justified using consequentialism 171 00:07:09.600 --> 00:07:11.130 are in fact inherently wrong 172 00:07:11.130 --> 00:07:14.220 regardless of any good possible outcomes. 173 00:07:14.220 --> 00:07:17.730 In healthcare, some actions that might offer the perception 174 00:07:17.730 --> 00:07:20.823 of positive outcomes could still be ethically problematic. 175 00:07:22.620 --> 00:07:24.600 An example of this is a provider 176 00:07:24.600 --> 00:07:26.100 refraining from certain diagnostic 177 00:07:26.100 --> 00:07:27.300 or therapeutic interventions 178 00:07:27.300 --> 00:07:29.940 to minimize patient pain or discomfort in the short term, 179 00:07:29.940 --> 00:07:31.860 but the patient then losing out on the benefits 180 00:07:31.860 --> 00:07:33.860 of those interventions in the long term. 181 00:07:35.010 --> 00:07:36.510 Consequentialist thinking 182 00:07:36.510 --> 00:07:39.240 might support sacrificing the individual rights of a person 183 00:07:39.240 --> 00:07:41.640 or small group to justify positive outcomes 184 00:07:41.640 --> 00:07:43.353 for a larger group of patients. 185 00:07:44.640 --> 00:07:48.809 Another theory we'll discuss is deontology, 186 00:07:48.809 --> 00:07:51.750 and deontology refers to the approach to ethics 187 00:07:51.750 --> 00:07:55.170 based on moral reasoning, rules, and obligations. 188 00:07:55.170 --> 00:07:56.538 Some of these rules 189 00:07:56.538 --> 00:08:00.090 and guiding principles can be stated as follows: 190 00:08:00.090 --> 00:08:03.810 Act always in such ways that the maximums of your actions 191 00:08:03.810 --> 00:08:05.790 can become general legislation. 192 00:08:05.790 --> 00:08:06.930 We have a moral obligation 193 00:08:06.930 --> 00:08:09.720 to do what our conscience perceives as right. 194 00:08:09.720 --> 00:08:11.820 And act in such ways that you treat yourself 195 00:08:11.820 --> 00:08:14.400 or any other human not as a mere tool, 196 00:08:14.400 --> 00:08:16.653 but as a purpose of its own. 197 00:08:17.820 --> 00:08:20.310 In global health context, deontology has the advantage 198 00:08:20.310 --> 00:08:22.110 of treating every human being with respect 199 00:08:22.110 --> 00:08:24.660 and protecting individuals' dignity. 200 00:08:24.660 --> 00:08:26.370 However, different people's consciences, 201 00:08:26.370 --> 00:08:27.780 which reflect personal opinions 202 00:08:27.780 --> 00:08:29.880 as well as cultural and religious backgrounds, 203 00:08:29.880 --> 00:08:31.470 may lead people to different decisions 204 00:08:31.470 --> 00:08:32.793 in specific situations. 205 00:08:34.410 --> 00:08:37.333 Finally, that leads us to the concept of principlism. 206 00:08:38.580 --> 00:08:40.170 Because ethicists in healthcare 207 00:08:40.170 --> 00:08:41.910 have not reached a general consensus 208 00:08:41.910 --> 00:08:44.879 on either consequentialism or deontology, 209 00:08:44.879 --> 00:08:48.540 the third approach of principlism has gained prominence. 210 00:08:48.540 --> 00:08:49.890 This is an ethical approach 211 00:08:49.890 --> 00:08:52.764 based on four basic principles of bioethics: 212 00:08:52.764 --> 00:08:57.510 beneficence, nonmaleficience, autonomy, and justice, 213 00:08:57.510 --> 00:09:00.180 which we'll discuss in the next slide. 214 00:09:00.180 --> 00:09:03.660 So beneficence refers to the principle of doing good, 215 00:09:03.660 --> 00:09:06.000 doing the best for the patient. 216 00:09:06.000 --> 00:09:08.880 Nonmaleficience refers to doing no harm, 217 00:09:08.880 --> 00:09:11.520 try to prevent negative consequences. 218 00:09:11.520 --> 00:09:14.580 Autonomy means to respect the free will of the patient, 219 00:09:14.580 --> 00:09:16.650 ensure informed consent. 220 00:09:16.650 --> 00:09:19.200 And finally, justice refers to treating all patients 221 00:09:19.200 --> 00:09:20.460 in similar situations equally 222 00:09:20.460 --> 00:09:23.283 in the best possible way without discrimination. 223 00:09:24.990 --> 00:09:26.760 Based on these principles, 224 00:09:26.760 --> 00:09:28.410 principlism has become the most commonly accepted 225 00:09:28.410 --> 00:09:29.940 ethical approach in bioethics 226 00:09:29.940 --> 00:09:32.280 and specifically in global health ethics. 227 00:09:32.280 --> 00:09:34.050 It provides an understandable framework 228 00:09:34.050 --> 00:09:36.990 for the decision-making process of healthcare practitioners, 229 00:09:36.990 --> 00:09:38.850 and it can be adapted to various cultural 230 00:09:38.850 --> 00:09:40.233 and religious backgrounds. 231 00:09:41.490 --> 00:09:44.310 It's important to note, however, that in practical medicine, 232 00:09:44.310 --> 00:09:46.620 the four principles may sometimes come into conflict 233 00:09:46.620 --> 00:09:47.493 with one another. 234 00:09:50.100 --> 00:09:52.230 Now, let's discuss some practical ethical issues 235 00:09:52.230 --> 00:09:53.630 in global health management. 236 00:09:54.960 --> 00:09:59.490 It's very important to avoid cultural ignorance, 237 00:09:59.490 --> 00:10:02.304 and one way to do this is by promoting cultural sensitivity 238 00:10:02.304 --> 00:10:03.870 within your own training 239 00:10:03.870 --> 00:10:06.303 and within the overall organizational culture. 240 00:10:07.980 --> 00:10:09.990 Oftentimes, when we look at global health, 241 00:10:09.990 --> 00:10:11.160 foreign aid is delivered by people 242 00:10:11.160 --> 00:10:13.860 who do not understand the local culture, language, 243 00:10:13.860 --> 00:10:15.510 and ways of life. 244 00:10:15.510 --> 00:10:17.550 Healthcare managers who lack cultural understanding 245 00:10:17.550 --> 00:10:19.740 will have difficulty not only in cooperating 246 00:10:19.740 --> 00:10:21.510 with local providers and colleagues, 247 00:10:21.510 --> 00:10:25.800 but also in working with programs-intended beneficiaries. 248 00:10:25.800 --> 00:10:30.800 It's very important to deeply understand the cultures 249 00:10:30.990 --> 00:10:31.980 within which you work 250 00:10:31.980 --> 00:10:35.733 and within which the organization you lead works. 251 00:10:37.770 --> 00:10:39.480 Now, let's discuss some examples 252 00:10:39.480 --> 00:10:41.550 of managerial ethics issues, 253 00:10:41.550 --> 00:10:43.500 more specifically about broad principles 254 00:10:43.500 --> 00:10:45.300 of cultural ignorance. 255 00:10:45.300 --> 00:10:50.300 So one, leftover medicine refers to the event 256 00:10:51.330 --> 00:10:54.300 when global health managers are often tempted 257 00:10:54.300 --> 00:10:57.120 to promote medical exports from their own country of origin 258 00:10:57.120 --> 00:10:59.580 when working with a recipient country. 259 00:10:59.580 --> 00:11:01.380 These exports might include medical equipment 260 00:11:01.380 --> 00:11:02.970 for diagnosis and therapy, 261 00:11:02.970 --> 00:11:05.223 as well as medications and other supplies. 262 00:11:06.120 --> 00:11:08.400 However, bringing such products to a country 263 00:11:08.400 --> 00:11:10.650 can come to be a problem. 264 00:11:10.650 --> 00:11:12.750 The continued imported products over the long term 265 00:11:12.750 --> 00:11:14.490 can hurt local efforts to manufacture 266 00:11:14.490 --> 00:11:16.050 or sell similar products, 267 00:11:16.050 --> 00:11:19.380 which thereby hamper efforts for self-sufficiency. 268 00:11:19.380 --> 00:11:23.220 One example of this is Gavi or the Global Vaccine Alliance, 269 00:11:23.220 --> 00:11:24.750 and I encourage you to look more into that 270 00:11:24.750 --> 00:11:27.210 and their schema for providing vaccines 271 00:11:27.210 --> 00:11:29.452 manufactured in other countries, 272 00:11:29.452 --> 00:11:32.313 two countries in the global south for examples. 273 00:11:34.230 --> 00:11:36.150 Other examples include tensions 274 00:11:36.150 --> 00:11:38.280 between local and traditional medicine 275 00:11:38.280 --> 00:11:40.710 and evidence-based medicine, 276 00:11:40.710 --> 00:11:44.712 or quote, unquote, "indigenous and western medicine." 277 00:11:44.712 --> 00:11:47.160 Oftentimes, global health organizations 278 00:11:47.160 --> 00:11:49.590 that are not culturally informed 279 00:11:49.590 --> 00:11:54.590 are likely to dismiss local healthcare practices 280 00:11:55.620 --> 00:11:57.030 because of their not being based 281 00:11:57.030 --> 00:11:59.763 in the traditional western medical canon. 282 00:12:01.919 --> 00:12:06.180 Other times, people who wish to participate 283 00:12:06.180 --> 00:12:07.110 in global health programs 284 00:12:07.110 --> 00:12:09.310 are not sufficiently qualified for this job. 285 00:12:10.291 --> 00:12:13.140 This might take place when medical students 286 00:12:13.140 --> 00:12:16.320 and even nonmedical personnel are highly enthusiastic, 287 00:12:16.320 --> 00:12:19.830 but lacking in medical skills and qualifications 288 00:12:19.830 --> 00:12:22.830 and end up working on a particular health situation 289 00:12:22.830 --> 00:12:26.670 of a recipient country in a patient care sense. 290 00:12:26.670 --> 00:12:28.833 This we refer to as guinea pig healthcare. 291 00:12:30.218 --> 00:12:32.850 That is the treating of people from the global south 292 00:12:32.850 --> 00:12:35.268 or recipient countries as guinea pigs, 293 00:12:35.268 --> 00:12:37.590 despite people not being licensed 294 00:12:37.590 --> 00:12:40.293 to practice the same skills in their own country. 295 00:12:42.690 --> 00:12:45.210 There are other examples of issues listed on the slide 296 00:12:45.210 --> 00:12:48.903 that I encourage you to examine in the chapter this week. 297 00:12:50.340 --> 00:12:54.840 So finally, there are some more key principles 298 00:12:54.840 --> 00:12:57.030 and strategies that one can employ 299 00:12:57.030 --> 00:12:58.680 to learn how to be an effective 300 00:12:58.680 --> 00:13:01.080 and ethical global health manager. 301 00:13:01.080 --> 00:13:03.873 The first is social and cultural observation. 302 00:13:05.190 --> 00:13:09.480 One way to learn about the culture of a particular place 303 00:13:09.480 --> 00:13:11.610 and become more culturally under informed 304 00:13:11.610 --> 00:13:13.620 is to read about the country before arriving 305 00:13:13.620 --> 00:13:16.180 or while working there to engage deeply 306 00:13:17.160 --> 00:13:22.050 with local practitioners and local professionals, 307 00:13:22.050 --> 00:13:24.540 and to make observations when you're in that country 308 00:13:24.540 --> 00:13:29.070 of particular practices. 309 00:13:29.070 --> 00:13:32.538 Such practices can be related to respect 310 00:13:32.538 --> 00:13:37.538 or other principles or concepts. 311 00:13:38.250 --> 00:13:39.870 And these may be unfamiliar to you 312 00:13:39.870 --> 00:13:42.900 or they may be not practiced in your home country, 313 00:13:42.900 --> 00:13:44.100 but they're important to understand 314 00:13:44.100 --> 00:13:45.950 in the recipient country nonetheless. 315 00:13:47.160 --> 00:13:49.140 It's also important to understand 316 00:13:49.140 --> 00:13:50.550 your own religious influence 317 00:13:50.550 --> 00:13:52.710 and how that potentially impacts 318 00:13:52.710 --> 00:13:55.590 and influences your actions in the global health context 319 00:13:55.590 --> 00:13:58.830 as well as the beneficiaries. 320 00:13:58.830 --> 00:13:59.730 One way to do this 321 00:13:59.730 --> 00:14:03.885 is to look at the predominant religions in a country 322 00:14:03.885 --> 00:14:06.420 and the religious makeup in particular regions or cities 323 00:14:06.420 --> 00:14:07.803 in which you'll be working. 324 00:14:09.210 --> 00:14:12.270 Another valuable tool for managerial preparation 325 00:14:12.270 --> 00:14:14.520 can be graduate and professional education, 326 00:14:14.520 --> 00:14:16.260 what you all are doing right now. 327 00:14:16.260 --> 00:14:20.446 However, that should not be treated as the final step 328 00:14:20.446 --> 00:14:23.100 in learning how to be an effective major, 329 00:14:23.100 --> 00:14:25.680 or an effective manager. 330 00:14:25.680 --> 00:14:28.789 The study of ethics and morality is a lifelong endeavor, 331 00:14:28.789 --> 00:14:31.710 and you'll constantly have to be aware 332 00:14:31.710 --> 00:14:35.310 and eager to learn about the specific concepts 333 00:14:35.310 --> 00:14:37.623 and specific context in which you work.