My first encounter with the term "complicitor" was in a book by Bazerman,1 titled Complicit: How We Enable the Unethical and How to Stop. Bazerman explores all facets of complicity, an action or inaction that creates and enhances harm to others through one's open or tacit cooperation with the wrongdoer. Sound familiar? When was the last time you witnessed the verbal attack of a colleague? You may have sympathized after the fact but did nothing during the incident. When was the last time you remained silent in the face of problematic decisions that harmed nurses or students? How many times in the last few months have you decided to "stay under the radar" instead of questioning policy or practices or challenging an aggressor or bully?? In more than 40 years of encouraging nurses to behave assertively and to manage their stress through speaking up, I did not pay enough attention to the rationale for and the negative effects of complicity.
At the core of complicity is self-protection. If we defend a colleague, we may be the next victim or face retaliation such as difficult assignments, losing rewards or a promotion, or even getting fired. Misplaced loyalty to the aggressor or to the offending organization may also drive our passivity. Better to remain silent than risk retribution or forego rewards. Bazerman offers the following strategies to not only confront complicity but also diminish the risk of ethical action1(pp178-197): First, increase your value to the organization in which you work so that managers and colleagues rely on you for perspective, good sense, and sound decision-making. Your rising indispensability will lessen the risk to your speaking out or acting when negative situations occur. Whether witness or victim of a transgression, document the incident in detail for future reference. Written accounts are powerful tools in changing people and organizations. Collaborate with like-minded colleagues; share what you have seen, how you see it, and what might be done to prevent future incidents. Ethical decision-making can be easier when enhanced by the power of the group.
As you think about your own acts of complicity, don't be too hard on yourself. Your fear of speaking out may be justified, given the level of toxicity in your environment. However, you can reframe that fear and experiment with new and creative responses that lead to positive change. You also need an exit strategy for self-care and protection. Given the current demand for nurses, you will have many options. Finally, health care organizations need to encourage dialogue among all staff levels in the effort to create ethical work environments. Ignoring problems leads to increased negativity and the pain of chronic complicity. Remember the words of Martin Luther King, "In the end, we will remember not the words of our enemies but the silence of our friends."2
-Gloria F. Donnelly, PhD, RN, FAAN, FCPP
Editor in Chief
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