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Writer's pictureJohn W Bailie, PhD

Say More than “No”

Updated: Feb 18, 2019


What do you do when your organization asks you to do something unethical?


A Leading Conflict subscriber recently posed this question to me. They were facing a tough situation. Their supervisor was informally pressuring them to falsify performance data for certain people served by the institution. The subscriber asked for some advice.


Of course, you can simply follow Nancy Reagan’s advice on avoiding temptation and just say no. But sometimes, there are opportunities to say no in a way that helps the organization learn from the experience and regain its ethical compass.

It is somewhat easy to just say no to an unethical temptation when you can walk away from the situation. But temptations to do the wrong thing usually come from the people closest to us – whether a friend, family member or colleague. And when you can’t just walk away from the situation, you need to say more than “no”.


I shared a story with the subscriber.


Early in my career, I worked as an emergency room crisis counselor for a large mental health organization. We routinely served people with severe mental health and/or substance abuse issues.


Our patients were often suicidal, high on drugs, in the midst of withdrawal, or experiencing some manner of acute psychosis. Some of them were homeless. Some of them were lawyers or laborers. You never knew who would show up or what situation might present itself during any given shift.


We met people in the most unstable, extreme, and volatile periods of their lives. Our job was to take it as it came, treat people with dignity, and get them the help they needed.


We sometimes played a role in recommending temporary involuntary commitment when someone was an active danger to themselves or others. In these cases, we occasionally needed to call hospital security if someone was a flight risk or posed a threat to staff.


None of the counseling staff were trained or certified in restraint techniques – nor was this a part of our job description. However, one of the crisis counseling staff supervisors began requesting that we physically restrain patients if they attempted to leave without permission and security wasn’t there to stop them.


I understood why the request was being made. There had been several patient “escapes” that required police intervention in the surrounding neighborhood and had garnered media attention (i.e. mental health patients running down the street in a hospital gown while being chased by the cops).


The local community was becoming concerned about safety. This was damaging the institution’s reputation. There was tremendous pressure from above to improve security within the crisis unit of the emergency room.


I was unwilling to agree to the request, which I considered to be both ethically and legally unsound. However, I wanted to respond in a way that also acknowledged that there was a real problem in need of a real solution.

In a series of staff meetings, with the team and supervisor present, I asked a series of questions about the request:

  • Is restraining patients a part of our job description as crisis counselors? (The answer was “no”.)

  • Has anyone on the crisis staff been formally trained and certified to perform these types of restraints? (The answer was “no”.)

  • Given those facts, are you requesting that we restrain patients anyway? (The answer was very confusing and muddled.)

  • Can you explain how the organization will manage the liability in the case of a lawsuit by an injured patient? (The answer was, “I have no idea”.)

  • Given the above, does it still seem fair or wise to request that untrained staff restrain patients? (The answer was, “I suppose not…”)

The supervisor then said, somewhat frustrated, “Well, just make sure that you request a security presence if you even suspect a patient will be volatile or might flee.”


That was the correct answer and led us into a more nuanced discussion about how to collaborate and communicate more effectively with the security staff, which was the real crux of the issue. Security typically complained if they were called to the unit when there wasn’t an immediate crisis. Yet, security often arrived too late once a patient decided to bolt for the door or otherwise cause chaos.


After a few tough meetings between the security and counseling staff, we sorted things out and largely solved the problem.


Sometimes, there is tremendous pressure to do something that everyone knows is against the rules or is ethically questionable. The next time you are in this position, consider how you can ask challenging and reflective questions that put leadership in a position that pressures them to either:

  1. Admit plainly that they are asking staff to do something unethical or against policy, or

  2. Slow down and find another solution to what is likely a real problem that deserves a more thoughtful solution.

Unethical decisions often begin as an attempt to provide a quick solution to a real problem. When this happens, slow things down. Use reflective questions to help the team not take the easy way out of a tough situation.

Be challenging and supportive. Whenever possible, say more than “no”.


Check out the Leading Conflict store for practical and hard-hitting resources that will help you put these ideas into action.


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