The moral responsibility of the hospital

The hospital has legal liability. Does it also have moral responsibility? Is it a moral agent, and if so in what sense? There are two issues involved, one conceptual and the other normative. The conceptual issue is whether a hospital can be morally responsible. If seen not only as a physical facility but as a formal organization, it can be said to act rationally, choose between alternatives, and affect human beings. It thus satisfies the criteria for moral responsibility, even though it is not a person. Though moral responsibility can be attributed intelligibly to a hospital, such responsibility can be assumed only by those within it who act for it. Such responsibility is agent responsibility and may be shared in a number of ways. Hospital responsibilities can be separated from the professional moral responsibility and the personal moral responsibility held by doctors, nurses, and others within a hospital. Assuming these three types of responsibility makes possible conflicts of responsibility for those who hold them. Normatively, the moral responsibility of the hospital is appropriately limited by its purpose and is primarily administrative. It has designatable moral responsibilities to its patients, doctors and nurses, and the public. These can be distinguished from the responsibilities of doctors and nurses to the public. The responsibility of a doctor on the hospital staff is different from the responsibility of a doctor who simply practices in the hospital; that of a staff nurse from that of a private nurse. The difference is in large part a function of the one sharing the responsibility of the hospital and the other not. An analysis of a hospital's moral responsibilities suggests structures appropriate to a hospital that wishes to meet its moral responsibilities.