The ethics of artificial intelligence is a widely discussed topic. There are numerous initiatives that aim to develop the principles and guidance to ensure that the development, deployment and use of AI are ethically acceptable. What is generally unclear is how organisations that make use of AI understand and address these ethical issues in practice. While there is an abundance of conceptual work on AI ethics, empirical insights are rare and often anecdotal. This paper fills the gap in (...) our current understanding of how organisations deal with AI ethics by presenting empirical findings collected using a set of ten case studies and providing an account of the cross-case analysis. The paper reviews the discussion of ethical issues of AI as well as mitigation strategies that have been proposed in the literature. Using this background, the cross-case analysis categorises the organisational responses that were observed in practice. The discussion shows that organisations are highly aware of the AI ethics debate and keen to engage with ethical issues proactively. However, they make use of only a relatively small subsection of the mitigation strategies proposed in the literature. These insights are of importance to organisations deploying or using AI, to the academic AI ethics debate, but maybe most valuable to policymakers involved in the current debate about suitable policy developments to address the ethical issues raised by AI. (shrink)

This paper offers an alternative to deontological and utilitarian approaches to making ethical decisions and taking good actions by organisational leaders. It argues that the relational and context-dependent nature of leadership necessitates reference to an ethical approach which explicitly takes these aspects into account. Such an approach is offered in the re-conceptualisation of ethical action on the part of leaders as a process of "coming into right relation" vis-à-vis those affected by their decisions and actions. Heidegger's notion (...) of "dwelling" is explored as a means of "coming into right relation". Three aspects of dwelling: "staying with", "comportment" and "active engagement" are described and ways in which they might be practically enacted by leaders are suggested. The paper concludes by reflecting on the ways adopting a "dwelling" approach to resolving ethical issues implies a re-conceptualisation of leadership itself. (shrink)

When we design information technology we risk building specific metaphors and models of human activities into the technology itself and into the embodied activities, work practices, organisational cultures and social identities of those who use it. This paper is motivated by the recognition that the assumptions about human activity used to guide the design of particular technology are made active, in use, by the interaction design of that technology. A fragment of shared design work is used to ground an exploration (...) of different solutions to one of the technical problems that arise when technology is used to support similar work over distance. The argument is made that some solutions to design problems are better than others because they enable human interaction in different ways. Some solutions enhance the possibilities for human agency, others diminish it. This means that there can be a moral basis for choosing between alternative interaction design decisions that might otherwise be considered equivalent in terms of the functionality and usability of the technology. (shrink)

. This descriptive study discusses cognitive mapping as a technique for analyzing ethical sensitivity, examines whether the method allows comparisons between people, compares the ethical sensitivity levels of participants from three organizations, examines which indicators of ethical sensitivity are most salient to members of specific organizations, and examines whether education level or organizational membership is the best predictor of an individual’s ethical sensitivity level. Subjects from three organizations read background information, listened to two audiotaped scenarios (...) containing multiple ethical issues related to organizational communication, responded to focused interview questions, and completed questionnaires. The interviews were taped, transcribed, and analyzed using cognitive mapping techniques. Significant differences in levels of ethical sensitivity were found between the members of the three organizations. However, a hierarchical regression model demonstrated that the difference was likely due to the differences in level of education in each organization. Organizational membership seemed to affect the particular aspects of the scenarios that participants noticed. (shrink)

The aim of the study was to report the results of a systematically conducted literature review of empirical studies about healthcare organizations’ ethics and management or leadership issues. Electronic databases MEDLINE and CINAHL yielded 909 citations. After a two stage application of the inclusion and exclusion criteria 56 full-text articles were included in the review. No large research programs were identified. Most of the studies were in acute hospital settings from the 1990s onwards. The studies focused on ethical (...) challenges, dilemmas in practice, employee moral distress and ethical climates or environments. Study samples typically consisted of healthcare practitioners, operational, executive and strategic managers. Data collection was mainly by questionnaires or interviews and most of the studies were descriptive, correlational and cross-sectional. There is need to develop conceptual clarity and a theoretical framework around the subject of organizational ethics and the breadth of the contexts and scope of the research needs to be increased. (shrink)

Based on a general review of international, representative tissue banking policies that were described in the medical, ethics, and legal literature, this paper reviews the range of standards, both conceptually and in existing regulations, relevant to four main factors:(1) commercialization, (2) confidentiality, (3) informed consent, and (4) quality of research. These four factors were selected as reflective of some of the major ethical considerations that arise in the conduct of tissue banking research. The authors emphasize that any policy or (...) ethical guidelines designed to regulate tissue bank research should address all four factors. Whenever this sort of research is conducted between several institutions or several countries, the paper suggests that the relevant entities work collaboratively to harmonize their standards. (shrink)

Dr Goffee reviews empirical evidence on the labour market position and work experience of women managers, assesses the kind of work situations which are likely to be perceived by women managers ‐ and, in some cases, their partners and colleagues ‐ as involving an “ethical” dimension, and suggests possible sources of differentiation in the experiences of European women managers which are worthy of further comparative research. The author is Associate Professor of Organisational Behaviour at London Business School.

The existing literature on the relationship between organizational commitment and ethical decision making suggests that ethical decision makers with higher organizational commitment are less likely to engage in ethically questionable behaviors. The ethical behaviors previously studied in an organizational commitment context have been organization-harm issues in which the organization was harmed and the individual benefited (e.g., overstating an expense report). There is another class of ethical issues in an organizational context, (...) however. These other issues, termed organization-gain issues, focus on the organization obtaining a benefit while outsiders, such as investors, are harmed (e.g., overstating reported revenue). We explore whether individuals with higher organizational commitment are more or less likely to engage in questionable behaviors that benefit the organization. Results of our study indicate that individuals with higher organizational commitment are less likely to engage in ethically questionable behaviors, regardless of whether the behaviors are organization-harm or organizational-gain issues. (shrink)

Ethics are of interest to business scholars because they influence decisions, behaviors, and outcomes. While scholars have increasingly shown interest in business ethics as a research topic, there are a mounting number of studies that examine ethical issues at the organizational level of analysis. This manuscript reports the results of a systematic review of empirical research on organizational ethics published in a broad sample of business journals over a 33-year period. A total of 184 articles are (...) analyzed to reveal gaps in the literature and, subsequently, lead to suggestions for future research; this is done in an effort to stimulate and perpetuate high quality research that more broadly impacts business scholars and practitioners. (shrink)

Over the past two decades, Victor and Cullen’s (Adm Sci Q 33:101–125, 1988 ) typology of ethical climates has been employed by many academics in research on issues of ethical climates. However, little is known about how managerial practices such as communication and empowerment influence ethical climates, especially from a functional perspective. The current study used a survey of employees from Taiwan’s top 100 patent-owning companies to examine how communication and empowerment affect organizational ethical (...) climates. The results confirm the relationship between these two managerial practices and organizational ethical climates. We discuss our results and their implications for both future academic research and practice. (shrink)

Background: Giving money as a direct incentive for patients in exchange for depot medication has proved beneficial in some clinical cases in assertive outreach . However, ethical concerns around this practice have been raised, and will be analysed in more detail here.Method: Ethical concern voiced in a survey of all AO teams in England were analysed regarding their content. These were grouped into categories.Results: 53 of 70 team managers mentioned concerns, many of them serious and expressing a negative (...) attitude towards giving money for depot adherence. Four broad categories of ethical concern following Christensen’s concept were distinguished: valid consent and refusal , psychiatric paternalism , resource allocation , organisational relationships , with a residual category others and unspecified .Discussion: The main concerns identified are discussed on the background of existing ethical theories in healthcare and the specific problems of community mental health and AO. Points for practice are derived from this discussion. A way forward is outlined that includes informed consent and an operational policy in the use of incentives, further randomised controlled trials and qualitative studies, and continuing discussions with all stakeholders, especially service users. (shrink)

Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational (...) issues derived and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)

This book explores an undeveloped area in postmodern thought: organizational ethics. Ethical debates and analyses usually focus on a particular act or action, an actor, and/or how a secular society should address any of those particular persons or events. In the Post Modern age, ethical decisions and policies are characterized by moral and cultural pluralism. However, there is a second factor that complicates ethical and policy decisions even further. This book argues that in the postmodern age (...) ethical decisions often need to be understood as part of the decision making of organizations and bureaucracies. Organizational decisions often have direct bearing on the choices made by individuals. Two areas that exemplify postmodern issue are the areas of health care and education. For example the decision making of Admissions Officers in American higher education, are influenced by decisions that have been made by the university about the size of the class and the diversity of the class. Health Care organizations make policy decisions that affect every aspect of a patient’s care from admission to treatment and the types of care that are or are not offered. Both education and health care are the object of the significant investment of resources, both areas are value laden in postmodern, pluralistic societies, and yet we do not have a comprehensive method to understand them or evaluate them. This book is of interest to bioethicists, physicians, nurses, health care policy students, educational policy experts, students and government regulators. (shrink)

Over the past two decades, Victor and Cullen's (Adm Sci Q 33:101-125, 1988) typology of ethical climates has been employed by many academics in research on issues of ethical climates. However, little is known about how managerial practices such as communication and empowerment influence ethical climates, especially from a functional perspective. The current study used a survey of employees from Taiwan's top 100 patent-owning companies to examine how communication and empowerment affect organizational ethical climates. (...) The results confirm the relationship between these two managerial practices and organizational ethical climates. We discuss our results and their implications for both future academic research and practice. (shrink)

It is inevitable that physicians in training will be exposed to behavior by supervising physicians that the trainees find unethical. By nature these events are rare. It is imperative within any residency training program that resident physicians have immediate access to a meaningful review process in cases of moral conflict with supervising physicians. Here, I discuss the reasons why this issue must be recognized and what it entails. Most important, I discuss the procedural steps that are essential for the training (...) program to make this a meaningful safety mechanism in residency training. This issue is central to promoting conscious development of professionalism in clinical training. Physicians in training, especially resident physicians, need to be taught to value and protect their own professional integrity. The responsibility for fulfilling this ethical duty falls on the individual residency programs as well as the administrative organizations that regulate residency training. Thus, ensuring this process of review is an organizational ethical imperative. Availability of this process is fundamental to promoting and ensuring ethical behavior by all participants in residency training. (shrink)

When investigating the impact of organizational ethical context on individual ethical decision-making, past work has reported mixed results, with some studies indicating that a strong ethical work environment is associated with increased ethical reasoning, and other studies indicating that such an environment has little to no influence on the way ethical issues are addressed. Given these contradictory findings, we utilize multiple theoretical perspectives to assess the degree to which employees’ perceptions of ethical (...) values, ethical culture, and corporate social responsibility moderate the relationship between their ethical issue recognition and ethical judgments. Data obtained from employees of a financial services firm located primarily in the Midwestern United States supported the research hypothesis, with organizational ethical context weakening the recognition–judgment linkage. Results are compared to prior studies, and the managerial and research implications of the findings are discussed, along with the study’s limitations and suggestions for future inquiry. (shrink)

We present this special issue on positive organizational ethics (POE) to highlight those pursuing positive subjective experiences, positive attributes of individuals and groups, and positive practices that contribute to ethical and virtuous behavior in organizations. Although prior research has offered some insight in this area, there is still much to be learned about how to cultivate and sustain ethical strength in different types of organizations and how goodness can emerge from and in spite of human failings. After (...) describing the positive movement, we position POE as a discrete area of inquiry within the broader positive behavioral sciences, at the intersection of positive behavioral studies and business ethics. After defining our terms and purpose for creating the POE domain, we introduce the articles in this special issue. The introduction concludes with suggested topics for future research. (shrink)

Examination of the application of virtue ethics to business has only recently started to grapple with the measurement of virtue frameworks in a practical context. This paper furthers this agenda by measuring the impact of virtue at the level of the organisation and examining the extent to which organisational virtue impacts on moral attentiveness and the perceived role of ethics and social responsibility in creating organisational effectiveness. It is argued that people who operate in more virtuous organisational contexts will be (...) expected to be more attentive to ethical issues and in turn perceive a greater role for ethics and social responsibility in business. Analysis of results based on a sample of 137 HR professionals shows that where people report that their organisation provides meaningful work, they are more likely to display reflective MA and the belief that ethics and social responsibility are compatible with business objectives, suggesting that organisations who are interested in promoting an ethical culture should focus on their work structures and practices. More generally, OV is shown to have a more complex relationship with PRESOR than hypothesised pointing towards a more nuanced view of OV. The paper examines the implications of the results for organisations and research. (shrink)

The day-to-day work of clinical ethics consultants and healthcare ethics committees can easily become overly routine. Too much routine, however, comes with a risk that morally important practices will be reduced to mere bureaucratic formalities, while practitioners become desensitized to ethically significant distinctions between cases. Clinical ethics consultation and organizational ethics must be set within the broader social and cultural context of the healthcare environment. This practice requires looking beyond mere legal compliance and the routinely false assumption that there (...) are unambiguous ethical norms that easily govern clinical ethics and hospital policy formation. Together the essays in this issue of HEC Forum challenge readers to rethink taken-for-granted assumptions regarding patient care, physician obligation, clinical ethics consultation, and organizational ethics. (shrink)

Patient engagement in healthcare is increasingly discussed in the literature, and initiatives engaging patients in quality improvement activities, organizational design, governance, and research are becoming more and more common and have even become mandatory for certain health institutions. Here we discuss a number of ethical challenges raised by this engagement from patients from the perspectives of research, organizational/quality improvement practices, and patient experiences, while offering preliminary recommendations as to how to address them. We identified three broad categories (...) of ethical issues that intersect between the different types of patient engagement: (1) establishing a shared vision about goals of patient engagement and respective roles; (2) the process and method of engaging with patients; and (3) practical aspects of patient engagement. To explain these issues, we build from our personal, professional, and academic experiences, as well as traditions such as pragmatism and hermeneutics that stress the importance of participation, empowerment, and engagement. Patient engagement can be highly valuable at numerous levels, but particular attention should be paid to the process of engaging with patients and related ethical issues. Some lessons from the literature on the ethics of participatory research can be translated to organizational and quality improvement practices. (shrink)

Background For the patients receiving care in the operating room, it emphasizes that the ethical behavior and attitude of health professionals should be aligned with patients’ basic human rights. Surgical ethics may provide an ethical alternative in a specific operating room context. However, it is unclear how actively research is being conducted in this regard. Aim This study determines the direction of future research by identifying ethical issues experienced in the operating room. Method This scoping review (...) is based on the methodological framework suggested by Arksey and O’Malley in 2005. PubMed, CINAHL, EMBASE, WOS, Cochrane, KISS, and KMbase databases were searched from January 2012 to May 2022. Two researchers independently screened the searched articles by reviewing the titles, abstracts, and full texts. Consequently, 19 studies were selected. Findings Five categories were identified: Professional ethics, Organizational ethics, Patients’ rights, Patient safety, and Allocating resources. The derived categories covered all the same content as the International Council of Nurses’ (ICN) code of ethics, with the exception of one element, that is, global health. Conclusions This study highlights ethical issues in the operating theatre and emphasizes the need for individual and organizational strategies aligned with the ICN code of ethics. Future research should cover a wider range of issues, employ diverse perspectives and methodologies, and enhance ethical practices to improve understanding and ethical practices in the field. (shrink)

BackgroundInvoluntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.MethodsIn-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The interviews were analysed using a descriptive qualitative approach.ResultsThe answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and why (...) it was justifiable to make a decision on involuntary treatment in a specific case. Here the cons and pros of ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors affecting decisions for or against involuntary treatment were also discussed. These included issues about the Swedish Mental Care Act, healthcare organisation and the care environment.ConclusionsInvoluntary treatment was generally seen as an unwanted exception to standard care. The respondents’ judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could have been avoided, given a more patient-oriented healthcare organisation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Organizational Ethics and Health Care: Expanding Bioethics to the Institutional Arena **Laura Jane Bishop (bio), M. Nichelle Cherry (bio), and Martina Darragh* (bio)In 1995, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) expanded its patient rights standards to include requirements for assuring that hospital business practices would be ethical. Renamed “Patient Rights and Organization Ethics,” these standards are based on the realization that a hospital’s obligation (...) to its patients is derived from two relationships: the patient-provider relationship governed by “clinical ethics,” and the customer-supplier relationship governed by “business ethics.” “[This] boundary between ‘clinical’ ethics and ‘business’ ethics is not clear and in many cases is nonexistent. While marketing and admission practices are seen as issues related to ‘business’ ethics, they can lead to unneeded admissions or demand for unneeded services, both of which can unnecessarily expose the patient to the risk of side effects or complications. Likewise, underutilization of needed services is likely to lead to less than optimal health outcomes” (I. Schyve 1996, p. 17). “These new standards arose out of well-publicized concerns about abuses in which patients were admitted to hospitals unnecessarily and were discharged or transferred only after their insurance expired” (I. Schyve 1996, pp. 15–16).These abuses also sparked eloquent protests against threats to patient well-being and to the nature of the patient-provider relationship in the bioethics literature. The fiduciary responsibility of the provider to inform and to protect the patient was fragmented by insurer business practices such as gag clauses and economic credentialing of providers (VII. Scope Note 31, 1996). The background role that the institution plays, though poorly articulated historically, has been brought sharply into focus by the explosive growth of the managed practice of medicine. The context of medical ethics is no longer limited to the resolution of individual cases, but instead encompasses the adoption of institutional structures to protect and promote patient welfare (IV. Emanuel 1995, p. 335). In this new configuration, the institution and the providers are co-fiduciaries for populations [End Page 189] of patients, and the medicine that is practiced is “appropriately economically disciplined.” The expression “My patient always comes first” is no longer “... intellectually serious or morally responsible.” But, “... to be sure, both conceptually and in practice, being an economically disciplined fiduciary professional or institution is ethically unstable.... The task is to identify the boundaries outside of which institutional policy and behavior will not count as an ethically defensible form of being... [a] fiduciary.” (IV. McCullough 1997, pp. 143–44). This process of delimiting and enforcing boundaries requires the development of “... a language for talking about the ethical values of the organization. If such a language does not exist, discussions about ethics become cumbersome and unlikely to occur” (IV. Cleveland Clinic Foundation 1998, p. 2).As with bioethics generally, the literature addressing organizational ethics is multidisciplinary. JCAHO’s compliance guide for its revised standards, Ethical Issues and Patient Rights, draws on a wealth of ideas from both clinical ethics and business ethics. This is often an awkward alliance. “Because the study of organizational ethics is in its infancy compared to other areas of healthcare ethics, discussions about it often seem like hot air with no palpable payoff” (I. Boyle 1998, p. 2). The fact that “... there is an ancient history that reflects widespread doubt about the moral probity of business” (II. Frederick 1995, p. 209) does not help. To begin, “Aristotle had rude things to say about business” (II. Jackson 1998, p. 401). A brief review of introductions to several of the business ethics textbooks cited in this bibliography reveals that a rebuttal of “business ethics as an oxymoron” is the standard opening paragraph. This stigma is unfounded, and “increased stability” has characterized the state of business ethics literature during the 1990s (II. Beauchamp and Bowie 1997, p. ix). Significant attention has been given to elaborating two often overlapping theories—stakeholder and social contractarian.Originating in the 1960s as a pun on “stockholder,” proponents of stakeholder theory claim that a corporation’s fiduciary responsibility extends beyond increasing its profitability to protecting the rights of individuals or groups affected by its actions. Popular as a strategic planning tool in the... (shrink)

Ethical challenges that arise within healthcare delivery institutions are currently categorized as either clinical or organizational, based on the type of issue. Despite this common binary issue-based methodology, empirical study and increasing academic dialogue indicate that a clear line cannot easily be drawn between organizational and clinical ethics. Disagreement around end-of-life treatments, for example, often spawn value differences amongst parties at both organizational and clinical levels and requires a resolution to address both the case at hand (...) and large-scale underlying system-level confounders. I refer to issues that contain elements of both clinical and organizational issues as hybrids and propose a new taxonomy to characterize hybrid cases. I contend that salient contextual features of an ethical issue, such as where it is identified, who it impacts and where it is ideally resolved in relation to its scope of impact, should inform procedure. Implementation of a Hybrid taxonomy viewing ethical issues as existing on a continuum furthers that end. The primary goals are to 1) systematize thinking about ethical issues that arise within healthcare delivery institutions and 2) allow the content of the ethical challenge to drive the process, rather than continuing to rely on the traditional binary issue-based choice. Failure to capture the complexity of hybrid situations perpetuates incomplete information and ultimately an inchoate resolution that creates more questions than answers. (shrink)

Responding to Randall and Gibson''s (1990) call for more rigorous methodologies in empirically-based ethics research, this paper develops propositions — based on both previous ethics research as well as the larger organizational behavior literature — examining the impact of attitudes, leadership, presence/absence of ethical codes and organizational size on corporate ethical behavior. The results, which come from a mail survey of 149 companies in a major U.S. service industry, indicate that attitudes and organizational size are (...) the best predictors of ethical behavior. Leadership and ethical codes contribute little to predicting ethical behavior. The paper concludes with an assessment of the relevant propositions, as well as a delineation of future research needs. (shrink)

Mental health professionals face many complex questions in the course of their work with clients and patients. Among the most difficult are dilemmas that involve ethical issues. This book presents a forthright exploration of these dilemmas and the ethical considerations they raise. Drawing on extensive interviews, the author identifies common ethical problems that practitioners encounter. What happens, for example, when personal interests intrude into therapy? How can the therapist make an accurate assessment of his or her (...) appropriateness as a care provider for a particular patient? What about confidentiality? How are problematic financial arrangements best addressed? The author goes on to show how these dilemmas may be intensified by the unique assumptions of different therapeutic orientations--individual, group, family, marital, and organizational--and how professionals can learn from such experiences to better understand and apply their particular approach. This analysis--and the words of the therapists themselves--provide both a guide to practice and a unique store of experience for the growing number of researchers and students concerned with ethical problems in psychotherapy. (shrink)

This study examined the ethical issues experienced by nurses working in a small group of elderly persons’ care settings in the UK, using a survey questionnaire previously used in other countries for examining the cultural aspects of ethical issues. However ‘culture’ relates not only to ethnicity but also the organizational culture in which care is delivered. Nurses working in elderly persons’ care settings described a range of issues faced when caring for elderly terminally ill (...) people, which illustrated the different needs of patients, relatives, professionals and society. These issues related to the unique needs of elderly people (such as dementia sufferers) and could have an impact on patients’ quality of death. (shrink)

This book offers a theoretical and practical overview of the specific ethical and legal issues in pediatric organ transplantation. Written by a team of leading experts, Ethical Issues in Pediatric Organ Transplantation addresses those difficult ethical questions concerning clinical, organizational, legal and policy issues including donor, recipient and allocation issues. Challenging topics, including children as donors, donation after cardiac death, misattributed paternity, familial conflicts of interest, developmental disability as a listing criteria, small (...) bowel transplant, and considerations in navigating the media are discussed. It serves as a fundamental handbook and resource for pediatricians, transplant health care professionals, trainees, graduate students, scholars, practitioners of bioethics and health policy makers. (shrink)

This paper examines the support for diversity from a moral perspective. Combining business ethics theory with a lens of critical discourse analysis, it reconstructs the debates on the ethicality of three disability inclusion practices—positive discrimination, job adaptations, and voluntary disclosure—drawn from multi-stakeholder interviews in disability-friendly organizations. Discursive resistance to disability inclusion practices, otherwise known to work, arises out of moral beliefs characteristic of an ethic of justice, whereas support is more often informed by an ethic of care. This study contributes (...) to the literature by laying bare how ethics fuel ‘resistance to’ rather than ‘support for’ diversity and inclusion. Like prior studies, it links such resistance to the myth of individual merit, noting that some re-appropriation of an ethic of justice becomes possible when legal awareness around issues of disability is raised in the context of work. In addition, it identifies an ethic of care as holding the greatest potential for fostering workplace inclusion yet cautions for two adverse side effects that may arise when promoting corporate care: the potential of paternalism and the inclination to individualise inherent to wellbeing initiatives. (shrink)

Crowdsourcing has attracted increasing attention as a means to enlist online participants in organisational activities. In this paper, we examine crowdsourcing from the perspective of its ethical use in the support of open innovation taking a broader system view of its use. Crowdsourcing has the potential to improve access to knowledge, skills, and creativity in a cost-effective manner but raises a number of ethical dilemmas. The paper discusses the ethical issues related to knowledge exchange, economics, and (...) relational aspects of crowdsourcing. A guiding framework drawn from the ethics literature is proposed to guide the ethical use of crowdsourcing. A major problem is that crowdsourcing is viewed in a piecemeal fashion and separate from other organisational processes. The trend for organisations to be more digitally collaborative is explored in relation to the need for greater awareness of crowdsourcing implications. (shrink)

In November, 1991, the U.S. Congress enacted the U.S. Federal Sentencing Guidelines legislation which had a dramatic impact on corporate America. Can the Guidelines be used as a model or framework by other countries? Could other countries in the world benefit from adopting a similar piece of legislation? Are there any limitations to consider? In addressing these issues, the authors make the argument that the time has arrived for other countries to consider the development of legislation similar to the (...) Guidelines in order to improve organizational ethics. (shrink)

This paper reexamines the perceived ethical issues and roles of employment managers based on their responses to a recent "Ethical Issues in Human Resource Management Survey." This research addresses five major questions including: 1) Whether employment managers' perceptions of the factors influencing unethical behavior vary according to gender, job position, and company size, 2) What are the perceived frequency and seriousness of misconduct among HR functional areas, 3) Whether groups of employment managers (i.e., males and females) (...) vary significantly in their perceptions of the seriousness of unethical events, 4) Whether gender and organizational level influence how often particular ethics roles are played, and 5) What particular roles are being played by employment managers as they respond to ethical dilemmas. The findings show that regardless of gender, position, or company size, employment managers' ethical behavior is influenced most by the behavior of senior managers and their immediate supervisors. In addition, the respondents believe that ethical misconduct occurs more often and is most serious in specialties such as employment, health, safety, and security, and compensation. Gender, industrial category, and company size have a significant impact on how serious unethical practices were perceived to be. Finally, seven of the eight ethics roles were matched with the ethical dilemmas submitted by the survey respondents. (shrink)

The 3rd Pan-African Ethics Human Rights and Medical Law (3rd EHRML) conference was held in Johannesburg on July 7, 2013, as part of the Africa Health Congress. The conference brought together bioethicists, researchers and scholars from South Africa, Zimbabwe, Kenya and Nigeria working in the field of bioethics as well as students and healthcare workers interested in learning about ethical issues confronting the African continent. The conference which ran with a theme of "Bioethical and legal perspectives in biomedical (...) research and medical practice in Africa with a focus on: Informed consent, HIV-AIDS & Tuberculosis, leadership & organizational ethics, patients and healthcare workers rights," was designed to expand the dialogue on African bioethics beyond the traditional focus on research ethics and the ethical dilemmas surrounding the conduct of biomedical research in developing countries. This introductory article highlights some of areas of focus at the conference including issues of leadership, organizational ethics and patients and healthcare workers rights in Africa. We analyze the importance of free speech, public debate of issues, argumentation and the need to introduce the teaching and learning of ethics to students in Africa in accordance with UNESCO guidelines. This article also focuses on other challenges confronting Africa today from an ethical standpoint, including the issues of poor leadership and organizational ethics which are main contributors to the problems prevalent in African countries, such as poverty, poor education and healthcare delivery systems, terrorism, social inequities, infrastructural deficits and other forms of 'structural violence' confronting vulnerable African communities. We believe that each of the eight articles included in this supplement, which have been rigorously peer-reviewed are a good example of current research on bioethics in Africa, and explore some new directions towards broadening the African bioethics agenda as we move forward to a new dawn for Africa in the 21st century. (shrink)

Definition of the problem Organizations, being important intermediaries of modern, highly differentiated, and pluralistic societies, are a key place of decision making. This especially applied to health care organizations. Arguments Organizations and their processes are reconceptualized and eminently challenged by digitization and cross-linking in the World Wide Web. Thus, organizational ethics also needs to be reconceptualized. Conclusion The paper provides scenarios of some of the crucial issues of organizational ethics in light of digitization.

Background: Decision-making and assessment in emergency situations are complex and result many times in ethical conflicts between different healthcare professionals. Aim: To analyse and describe situations that can generate ethical conflict among nurses working in emergency situations. Methods: Qualitative analysis. A total of 16 emergency nurses took part in interviews and a focus group. Ethical considerations: Organisational approval by the University Hospital, and informed consent and confidentiality were ensured before conducting the research. Result/conclusion: Two categories emerged: one (...) in ‘ethical issues’ and one in ‘emotions and feelings in caring’. The four ethical subcategories are presented: Autonomy, the first sub category: first, the nurse’s ability to practise care on an emergency ward and, second, to support the patient and/or relatives in terms of care and medical treatment. The conflicts arise when the nurse ends up in the middle between the patient and the physician responsible for the diagnosis and treatment from a nature scientific perspective. Reification of injured body: patient was often reified and fragmented, becoming just a leg or arm. Different factors contributed in this perspective. Pain: pain relief was often inadequate but more effectively treated in the emergency medical services than at the emergency department. The nurses highlighted the phenomenon of suffering because they felt that pain was only an object, forgetting the patients’ care need, like separating mind from body. Death: the nurses felt that the emergency services are only prepared to save lives and not to take care of the needs of patients with ‘end-of-life’ care. Another issue was the lack of ethical guidelines during a cardiac arrest. Resuscitation often continues without asking about the patient’s ‘previous wishes’ in terms of resuscitation or not. In these situations, the nurses describe an ethical conflict with the physician in performing their role as the patient’s advocate. The nurses express feelings of distress, suffering, anger and helplessness. (shrink)

Abstract:In this paper we highlight the emergence of organizational ethics issues in health care as an important outcome of the changing structure of health care delivery. We emphasize three core themes related to business ethics and health care ethics: integrity, responsibility, and choice. These themes are brought together in a discussion of the process of Mission Discernment as it has been developed and implemented within an integrated health care system. Through this discussion we highlight how processes of institutional (...) reflection, such as Mission Discernment, can help health care organizations, as well as corporations, make critical choices in turbulent environments that further the core mission and values and fulfill institutional responsibilities to a broad range of stakeholders. (shrink)

The aim of this thematic literature review is to explore nurses' perceptions of ethical issues in the care of older people. Electronic databases were searched from September 1997 to September 2007 using specific key words with tight inclusion criteria, which revealed 17 primary research reports. The data analysis involved repeated reading of the findings and sorting of those findings into four themes. These themes are: sources of ethical issues for nurses; differences in perceptions between nurses and (...) patients/relatives; nurses' personal responses to ethical issues; and the patient—nurse relationship. The findings reveal that ageism is one of the major sources of the ethical issues that arise for nurses caring for older people. Education and organizational change can combat ageist attitudes. Wider training is required in the care of older people, workplace skills, palliative care and pain management for older people. The demands of a changing global demography will necessitate further research in this field. (shrink)

As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their (...) institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones—law, care and ethics—constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice. (shrink)

Can ethical character be stimulated and enabled? Cognitive understanding of organizational ethics issues is important and necessary, but not sufficient. Ethical behavior does not emerge automatically. Effective political method is necessary. While it may be difficult to teach ethical character, nonetheless, skill development with respect to joined ethics understanding and action-learning methods can help us develop the skills and confidence we need to actualize our ethical characters and social concerns. An action-learning approach to (...) class='Hi'>organizational ethics can help stimulate and enable ethical character. (shrink)

Ethical climate (EC) has been broadly described as how well institutions respond to ethical issues. Developing a tool to study and evaluate EC that aims to achieve sustained improvements requires a contemporary framework with identified relevant drivers. An extensive literature review was performed, reviewing existing EC definitions, tools and areas where EC has been studied; ethical challenges and relevance of EC in contemporary paediatric intensive care (PIC); and relevant ethical theories. We surmised that existing EC (...) definitions and tools designed to measure it fail to capture nuances of the PIC environment, and sought to address existing gaps by developing an EC framework for PIC founded on ethical theory. In this article, we propose a Paediatric Intensive Care Ethical Climate (PICEC) conceptual framework and four measurable domains to be captured by an assessment tool. We define PICEC as the collective felt experience of interdisciplinary team members arising from those factors that enable or constrain their ability to navigate ethical aspects of their work. PICEC both results from and is influenced by how well ethical issues are understood, identified, explored, reflected on, responded to and addressed in the workplace. PICEC encompasses four, core inter-related domains representing drivers of EC including: (1) organisational culture and leadership; (2) interdisciplinary team relationships and dynamics; (3) integrated child and family-centred care; and (4) ethics literacy. Future directions involve developing a PICEC measurement tool, with implications for benchmarking as well as guidance for, and evaluation of, targeted interventions to foster a healthy EC. (shrink)

The latest volume of Research in Ethical Issues in Organizations examines a range of contemporary issues in applied and professional ethics and explores the unique role of organizational ethics in creating and sustaining a pluralistic, free enterprise economy.

Understanding of organizational ethics phenomena requires complex understanding of organizational practices in their real world contexts. We can try to understand and build theory about these complex real world practices from the points of view of: a traditional deductive, ethics literature-based, literature gap formulation approach; or, an inductive, practitioner-based literature gap formulation approach. This consideration of inductive, practitioner-based versus deductive, literature-based literature gap formulation is related to the discussion concerning “engaged scholarship” and relationships and gaps between theory and (...) practice in organization studies [Van De Ven, 2007, Engaged Scholarship: A Guide for Organizational and Research Knowledge ]. However, there is an important difference with respect to the key issue of ethics literature versus practitioner-based literature gap formulation. This article offers examples of the two different approaches and makes comparisons between them. Implications for practice-based organizational ethics theory building, Ph.D. education, and public intellectual work are considered. (shrink)

Whilst there is a growing volume of literature exploring the ethical implications of organisational change for HRM and the ethical aspects of certain HRM activities, there have been few published U.K. studies of how HR managers actually behave when faced with ethical dilemmas in their work. This paper seeks to enhance the foundations of such knowledge through an examination of the influence of organisational values on the ethical behaviour of Human Resource Managers within a sample of (...) charities in the U.K. and the Republic of Ireland. A qualitative research design is adopted utilising semi-structured interviews. Findings highlight ethical inconsistency in people management in the charity sector arising from the clear application of strong and explicit organisational values to external client groups but their limited influence on people management strategies and practices within the organisation. Many of the ethical issues faced by HRM professionals in both countries arise from this inconsistency. In their handling of ethical dilemmas, the HRM professionals exhibit a combination of a care ethic and a concern for justice but it is also clear that in situations of management intransigence, a desire to be conscience driven often gives way to a contingent approach. Whilst respondents considered it inappropriate for the HRM function to be the conscience of the organisation, it is seen to have a key role in providing management with advice on ethical action. However, the ability of HRM to influence ethical behaviour is highly dependent on the status of the function within the organisation. (shrink)

The accounting profession is concerned with the ethical beliefs of its members. To this end, the authors surveyed public accountants, questioning them about the AICPA''s Code of Professional Conduct and their perceptions of how potentially unethical behaviors impact the firm. The paper focuses on respondents'' perceptions of the impact on the firm''s practice, image and degree of concern.Public accountants appear to agree with the AICPA''s Code of Professional Ethics. Their mean responses indicate they believe the Code components are important (...) and extremely important. Some Code components were significantly more important than others, especially demonstrating professionalism and maintaining independence while performing independent audits. Gender, role and organizational level all had significant effects on the importance of the Code. Males, non-auditors and upper management all expressed stronger beliefs in the importance of the overall Code and its components. (shrink)

Jones's (1991) issue-contingent model of ethical decision making posits that six dimensions of moral intensity influence decision markers' recognition of an issue as a moral problem and subsequent behavior. He notes that "organizational settings present special challenges to moral agents" (1991, p. 390) and that organizational factors affect "moral decision making and behavior at two points: establishing moral intent and engaging in moral behavior" (1991, p. 391). This model, however, minimizes both the impact of organizational setting (...) and organizational factors on these experiences of ethical issues. In this theory, context is modeled as affecting the moral intent and behavior of the actor rather than directly affecting the issue's moral intensity. Here we look specifically at the effect of context on the moral intensity of ethical issues through a phenomenological study. Our results indicate that in certain environments, context may be critical in affecting the moral intensity of ethical issues. Thus, researchers should consider it more fully when assessing these issues' moral intensity. (shrink)

Research question and aim Clinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020, a CEC was established in an Oncology Research Hospital in the North of Italy. This paper describes the development process and the activities performed 20 months from the CEC’s implementation, to increase knowledge about CEC’s implementation strategy. Research design We collected quantitative data related to number and characteristics of CEC activities (...) carried out from October 2020 to June 2022 using the CEC internal database. Data were reported descriptively and compared with data from the literature to provide a complete overview of the CEC’s development and implementation process. Participants and research context The study has been conducted at the local health authority (LHA) of Reggio Emilia. It is a report of the activities provided by the CEC, where no HPs or patients were involved. Ethical Considerations The report is part of a larger study named EVAluating a Clinical Ethics Committee implementation process (EvaCEC), which has been approved by the Local Ethics Committee (AUSLRE Protocollo n° 2022/0026554 of 24/02/2022). EvaCEC is also the first author's PhD project. Findings In total, the CEC performed 7 ethics consultations (EC), published three policies related to particular ethical questions of clinical and organizational practice, provided one educational online course on ethics consultation targeting employed HPs, and promoted a specific dissemination process among the different departments of the LHA. According to our results, the CEC widely fulfilled the standard threefold set of clinical ethics support services tasks (namely, ethics consultation, ethics education, and policy development), but further investigations are needed to evaluate the CEC’s impact on clinical practice. Conclusion Our findings may increase knowledge regarding the composition, role, and tasks of a CEC in an Italian setting, informing future strategies and efforts to regulate these institutions officially. (shrink)

Background Ethical sensitivity is a prerequisite for ethical nursing practices. Efforts to improve nurses’ ethical sensitivity are required to correctly recognise ethical conflicts and for sound decision-making. Because an emerging infectious disease response involves complex ethical issues, it is important to understand the factors that influence public health nurses’ ethical sensitivity while caring for patients with COVID-19, an emerging infectious disease. Objectives This study aims to identify the relationship between nursing professionalism, the organisation’s (...) ethical climate, and the ethical sensitivity of nurses who care for emerging infectious disease patients in Korean public health centres. Further, it sought to identify factors influencing ethical sensitivity and the mediating effect of the organisational ethical climate to inform guidelines and improve ethical sensitivity. Research design This was a cross-sectional descriptive study. Participants and research context Data were collected from February 3 to 8 March 2021. Participants included 167 nurses caring for patients with COVID-19 in public health centres in South Korea. Ethical consideration This study was approved by the Institutional Review Board of the Chung-Ang University and followed the principles of research ethics. Results The factors influencing ethical sensitivity were working at a COVID-19 disease direct response department, nursing professionalism, and organisation’s ethical climate. The organisation’s ethical climate showed a partial mediating effect on the influence of nursing professionalism on ethical sensitivity. Conclusion Our findings show that nurses’ ethical sensitivity can be improved by refining the organisation’s ethical climate and nursing professionalism. (shrink)

The purpose of this paper is to explore the concepts of issue legitimacy and organizational legitimacy, providing a new measure of each construct. The scales were developed and tested using data collected through a statewide survey of Alabama residents. Assessments of issue legitimacy were based on perceptions of direct-to-consumer advertising, whereas assessments of organizational legitimacy were based on perceptions of the pharmaceutical industry as a whole. The findings provide evidence that organizational legitimacy can be reliably measured using (...) a five-item scale and issue legitimacy can be reliably measured using a six-item scale. The implications of the results and potential uses of the scales are discussed. (shrink)