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First principles: substantive ethics for healthcare organizations
Eva C Winkler1, Russell L Gruen
1Harvard Medical School, Harvard University Center for Ethics and the Professions, Boston, USA. Eva.Winkler@med.uni-muenchen.de
Summary
Healthcare organizations (HCOs) face ethical dilemmas. This study proposes four principles—compassionate care, employee respect, public spirit, and reasonable resource spending—to guide HCOs
Area of Science:
- Organizational Ethics
- Healthcare Management
Background:
- Healthcare organizations (HCOs) frequently encounter ethical dilemmas.
- Existing ethical frameworks primarily focus on clinical ethics, lacking specific guidance for organizational ethical decision-making in HCOs.
- Progress in business ethics has emphasized processes for responsible behavior in complex organizations.
Purpose of the Study:
- To propose a normative ethical framework for value-laden decision-making in healthcare organizations.
- To establish guiding principles for resolving ethical dilemmas faced by HCOs.
Main Methods:
- Development of a normative framework based on the multifaceted roles of HCOs.
- Derivation of four substantive ethical principles from these roles: caregiver, employer, citizen, and manager.
Main Results:
- Proposed principles: provide care with compassion, treat employees with respect, act in a public spirit, and spend resources reasonably.
- These principles are derived from the expected roles of HCOs.
Conclusions:
- The proposed framework can clarify and resolve ethical tensions within HCOs.
- Implementation of these principles is anticipated to enhance organizational values and public trust.
- The framework aims to aid societal discussions on the appropriate roles of healthcare organizations.