Barbara Russell
Is it ethical for employees of mental health and addiction programs to join big-prize lottery pools, perhaps even buying a ticket every week?
Four ethics-laden points are relevant to this question. First, gambling problems are not limited to the people we call our clients or patients. Work colleagues, too, may themselves experience problem gambling--in the past, present or future. In terms of business or organizational ethics, employees are expected to not intentionally risk one another's well-being. We have this ongoing duty to colleagues, I think, based on the humbling realization that yes, we can harm our colleagues -- no matter how much we rely on good intentions and being nice people. Moreover, drawing on two favourite concepts from bioethics, health care employees are expected to respect the personhood and humanity of one another, just as they are expected to do with their clients. We also owe the duty to not harm colleagues to our employers because each of us is expected to be a team player (unless, for some reason, the employer does not want this) and not damage what is valued by the employer.
A second ethics point to consider is one that I have learned from colleagues in the Problem Gambling Service at CAMH -- that is, the importance of knowing the different forms of gambling, the impact of advertising and their combined effects in terms of risks and allure. For instance, quick-pick or instant-win lottery tickets are particularly enticing for individuals whose gambling is damaging their significant relationships, employment, self-respect, and peace of mind.
A third point to think about is that deciding whether or not to buy weekly lottery tickets falls within the personal realm of our daily lives and interests. Organizing a shared ticket at work brings what is private and personal into what is public and work-focused. This personal activity must not become a new norm for the group because someone who decides not to participate is "marked" and left out of the everyday flow and conversations of the workplace. The ticket-buying group becomes, in essence, a club or clique. I use the word "clique" deliberately because many adults still remember the hurtfulness and fickleness of high school cliques. This dynamic can develop around any personal activity that takes place at work, whether it's lunch-time bridge on Tuesdays or rotating who is expected to bring a treat to the Friday morning meeting.
It's contradictory, too, to tolerate or adopt a "don't ask, don't tell" approach regarding an activity that can stigmatize and exclude in the very workplace that publicly advocates eliminating stigma and exclusion of people with mental health or addiction issues. Similarly, the workplace must not be a triggering environment for clients who have a gambling problem or who are at risk of developing one.
The final ethics consideration also stems from the fact that lotteries are a private activity. If a group decides to share in the weekly ticket purchase, it shouldn't be called something like the "XYZ addictions ticket" or "Depression Team ticket" because that links the employer's name (i.e., XYZ) or the work group's name (i.e., Depression Team) with something the employer has not approved. This relates to ethically worrisome conflicts of commitment and conflicts of interest because work time is being used and the publicly funded, health-promoting organization's public profile or reputation is at risk. Most employers have developed policies or guidelines of some kind to proactively identify and resolve these kinds of conflicts and to promote professional interactions throughout the organization.
In the end, it's ethically best and pragmatically wisest to organize a shared lottery ticket on personal time, in personal space. However, if you decide to organize it at work, you should consider the points I've raised to guide what they do to ensure that your colleagues and your work environment aren't harmed and that the activity could not be perceived as having employer approval or support.
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Barbara Russell, bioethicist at the Centre for Addiction and Mental Health in Toronto, answers ethics questions that arise in the mental health and addiction fields. She is connected with the University of Toronto's Joint Centre for Bioethics and heads the neuroethics interest group of the Canadian Bioethics Society. She is also a contributing editor to the Journal of Ethics in Mental Health.
Do you have an ethics question for Dr. Russell? Submit questions to be considered for this column to CrossCurrents editor Hema Zbogar at hema_zbogar@camh.net. Please omit personally identifiable health-related information in order to respect people's privacy and follow privacy legislation.
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