Does CCMC have a strong code of ethics?

By Mark E. Meaney, PhD

Health Care Ethicist

Center for Ethics in Health Care

St. Joseph’s Health System, Atlanta

If you aren’t familiar with the Code of Profes-sional Conduct for Case Managers developed by the Commission for Case Management Certification (CCMC) in Rolling Meadows, IL, and supported by the Case Management Society of America in Little Rock, AR, you should be. If you’re certified and haven’t read your copy of the code, do so, because violations place your certification in jeopardy.

A code of professional conduct is the hallmark of a professional association. With power and privilege comes responsibility. In exchange for your professional autonomy as a case manager, society holds you to a higher standard of conduct than that required of others. If you have further distinguished yourself by becoming certified in your profession, the implied contract between you and society is even stronger.

A code of professional ethics must meet certain minimum requirements. Those include:

o demonstrate that members will act to protect the public interest;

o regulate the actual conduct of members;

o provide evidence that members are held accountable to the requisite high moral standards;

o be specific and honest.

In addition, a code must go beyond basic societal sanctions against behaviors such as lying and stealing, and specifically address shady practices that, while not quite illegal, are nevertheless unethical. A code also must make provisions to bring charges and to apply penalties in case of illicit behavior.

Beyond the call

The CCMC code exceeds those minimum requirements. The code’s preamble states unequivocally that the primary purpose of the code is to protect the public interest. The code describes three standards: principles, rules of conduct, and guidelines for professional conduct. It also details the CCMC procedures for enforcement of ethical violations.

The code begins with a consideration of the legitimate aims and goals of the practice of case management. The case manager/client relationship is a fiduciary relationship. Clients are vulnerable and trust that case managers will promote their best interests. As advocates, case managers have an obligation to provide services consistent with their knowledge, skill, and power.

The code moves into a discussion of underlying values and general principles to discussion of the rules that regulate specific activities. High moral character is required to render appropriate services based on sound principles of practice. The values of respect, professional integrity, objectivity, and honesty are a means to achieve client wellness and empowerment.

Only case managers are in a position to understand how a member of their profession might abuse information and power without public awareness of their activities. Both the Rules of Conduct and Guidelines for Professional Conduct address the ethical dilemmas specific to case management. This is where it is important to understand what ethical dilemmas are not. They are not choices between the clearly right or the clearly wrong. Ethical dilemmas involve choices among least worse alternatives. (For more on case management ethics, see stories, at right and on p. 45.)

Only professionals with comparable knowledge can identify gray areas and restrain unprofessional or unethical conduct. The CCMC code identifies the ethical dilemmas specific to "dual relationships" and "conflicts of interest" as among the most troublesome for case managers. I will examine the code’s approach to those two complex issues in a future column.