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Health Care Leadership

The famous American writer Henry David Thoreau’s essay “Resistance to Civil Government” establishes a set of principles reconciling conscience and action. Its genesis inspired both civil rights leader Martin Luther King Jr. and the leader of Indian independence, Mahatma Gandhi. Both were great leaders who attempted to bring into harmony leadership, action and conscience. The essay holds lessons for today’s health care leaders because of the diversity of employees at contemporary health care organizations and the wide scope of patient demographics is in many ways similar to the structure of diversity in democratic government as understood in Thoreau’s essay. How health care organizations address change as a whole is in many ways closely aligned with patient preferences and requests, a similarity in function to how a democratic government addresses change.

“Resistance to Civil Government” explains that the aspirations of conscience decay and collapse upon themselves unless they are allowed to expand and influence an individual’s actions and self-expression. The desires of conscience are delineated in thought, through action, and in action, through thought. This reciprocal relationship of thought and action complements one another while rounding out the full identity of the individual. This may be illustrated through the principle that successful leaders fully embrace the mission of their health care organization.

In “Resistance to Civil Government”, Thoreau articulates that the dichotomy in society of praising individual conscience, while submitting individual action to the dictates of society and government, causes internal confusion within individual thinking. Thoreau explains that as long as citizens “serve their country as machines”, the conscience of the individual cannot fulfill its aspirations (p. 1540). A conscience, stifled by a conformist government or society, reduces the identity of the individual to a mere faceless part of a larger structure. An example of applying Thoreau’s principles to health care administration is illustrated by good leaders valuing the input of all employees because each holds unique perspectives and each employee should feel their opinions are valued.

Thoreau asserts great citizens “serve the state with their consciences’ also”(p.1540). Those who follow and accept the errors of the state are actually accessories to the state’s self-destruction. The non-conformists, following and acting upon their dictates of conscience, reject the government’s errors in the hope that it will correct itself. Health care leaders offering a culture of candor between themselves and their employees also create a culture of trust. When this culture of trust becomes reciprocal it can become a cycle of trust between leaders and their employees.

Although the essay “Resistance to Civil Government” has taught different lessons throughout history, its leadership principles are easily highlighted by health care leaders who believe in their organization’s mission while personally and professionally valuing the contribution of each employee. This fosters a culture of candor, and establishes a bond of trust and loyalty, solidifying the strength of the health care organization as a whole.


Paul Westerman is a member of the Chicago Health Executives Forum Education and Networking Committee and is the Medical Education Coordinator for Aurora Health Care in the Lake Geneva Area. He can be contacted at

Works Cited:
Thoreau, Henry David, The Norton Anthology of American Literature, Vol. 1, Nina Baym, General Editor, W. W. Norton & Company 2002

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