Ethics Q & A
September 26, 2005
By Jane Garthson, Garthson Leadership Centre
The question:
I recently joined an agency where staff are overloaded, and people who approach us for services are told there will be a four-month wait for a first appointment. But some people have been on the waiting list for over a year, and I see new people starting as clients without ever having been on the list. I am not involved in arranging appointments, but it bothers me. I thought first come, first served was the only ethical way to handle a line-up. Am I wrong?
Jane says...
There are both ethical and unethical ways of managing a waiting list in ways other than first come, first served.
You should probably ask if there is a policy document you could read, so you could learn more about how the organization operates. A policy document might outline a form of triage, where the most urgent cases are taken first, just as in an emergency room at a hospital. It might say that all homeless people are seen immediately because there is no way to reach them about appointment scheduling. It might say that a new baby of an existing client is automatically a client. It might say that clients are added based on who fits into group sessions that have a vacancy - so if a group of teenagers has a spot, the teenager highest on the list will be called rather than the person at the top of the list.
It is often more ethical to have objective, reasonable criteria like this than to stick to first come, first served - but then people being added to the list should be told. It is unethical to describe an average waiting time if their own waiting time is not likely to fit that pattern.
Does any of this sound like your workplace?
Unfortunately, there are also organizations that give precedence to family and friends of volunteers and staff. There are even occasional wrong-headed or untrained board members who feel that family preference is an automatic perk of board service. Using agency resources to give preference to family and friends is quite unethical. This is particularly true if a board member or executive director is involved, since they have the highest level of decision authority, and therefore the greatest responsibility to avoid conflicts of interest.
There might even be an employee taking bribes to move someone up the list, but I do not know of a Canadian agency where this has happened. If you become aware that someone is giving or taking bribes, report it so the agency can call the police.
Generally, if you see that the decisions about new clients are being made without objective reasonable decisions, you may wish to ask questions about the system. Be cautious until you are sure you understand what is happening.
Another problem with long waiting lists is that people often put themselves on several lists to see which agency takes them first. If no one does regular checks, a very long list may have only a few people really waiting. Grant-givers know that long lists are not necessarily an indication of community need, as the lists are so often poorly managed. People can be called to see if they are still interested, or agencies providing similar services could collaborate and set up a single waiting list system. That way, again, people can be given more realistic information when they sign up.
So first come, first served is only one option. It might be the best one for your organization or it might not. As with almost any decision in a nonprofit, you need to understand the mission and the community being served in order to choose the most ethical waiting list process.
Thank you for raising this issue. Perhaps a number of organizations will rethink their waiting list policy.
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Because nonprofit organizations are formed to do good does not mean
they always are good in their own practices. Send us your ethical questions
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more. Please identify yourself and your organization so we know the questions
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please contact help@charityvillage.com. For paid professional advice about an urgent or complex situation, contact Jane directly.
