At thirty-three years of age, I was the youngest administrator in New York State and was about to learn that adhering to company policies sometimes conflicts with the needs of patients. In this case, it was a thirty-eight-year-old employee who had been diagnosed with cancer. I remember the day well, even though it was more than thirty years ago. My secretary alerted me that Carol, a practical nurse and employee, had been admitted to the 3-North medical-surgical week, where she worked. Without delay, I left my office and went to the nursing week and inquired as to what room Carol was in.

Beth, the week's nurse manager, overheard my question. She walked up to me and asked, "Daniel, could I please talk to you for a moment before you visit Carol?" I looked at her and nodded my head yes, and without thought, we both walked into her office. She closed the door and said, "As you know, we are self-insured and the health insurance program that we have does not cover Carol's chemotherapy treatments. She cannot bear the cost. Is there anything you can do to help her?" I replied that I would make an inquiry with our human resources director to see what could be done.

Beth asked, "Would you mind if I went with you to Carol's room for a few minutes." Daniel compassionately replied, "Of course, you can." They walked to Carol's room. Her husband and children had just left. Beth stayed for a few minutes while Daniel remained behind chatting with Carol for a few moments and said he would be back to talk with her more.

Daniel went to speak with Christine, the human resources director for his hospital. There were two other hospitals in the multihospital system. He explained Carol's financial situation and her lack of funds for her chemotherapy treatment. Christine replied, "Daniel, this is a corporate policy that is applicable to all three hospitals with which we must comply." Following much discussion, Daniel said, "Christine, Carol is an employee, and I realize there are conflicting duties here.

One is to follow corporate policy or choose to do, as I see it, what is right for Carol. If you prefer, I can request an exception to the rule. To me, right trumps duty." Christine looked at Daniel and said, "Daniel, I will see what I can do. I have a good relationship with the corporate vice president for human resources. If anyone can make an exception, he can make it happen. I know you would do the same for me or any other employee."

1. Discuss at least three potential long-term effects of granting an exception for Carol.

1. Justify the position that doing the right thing is always more important that maximizing good and defend the argument that "right trumps duty." Be sure to provide examples from personal or professional scenarios.