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Updated: Feb 18, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
What Critical Ethical Values Guide Strategic Planning Processes in Health Care Organizations?
Matthew Kucmanic, Amy R Sheon1
1The executive director of the Urban Health Initiative at Case Western Reserve University School of Medicine in Cleveland, Ohio.
Abstract:
This case explores a fictitious hospital's use of co-creation to make a decision about redesign of inpatient units as a first step in incorporating stakeholder input into creation of governing policies. We apply a "procedural fairness" framework to reveal that conditions required for an ethical decision about space redesign were not met by using clinician and patient focus groups to obtain stakeholder input. In this article, we identify epistemic injustices resulting from this process that could undermine confidence in leadership decisions. Suggestions are offered for incorporating stakeholder input going forward that address prior shortcomings. The result should be conditions that are perceived as procedurally fair and decisions that engender confidence in institutional leadership.
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