Actions within organizational contexts should be understood differently as compared with actions performed outside of such contexts. This is the case due to the agentic shift, as discussed by social psychologist Stanley Milgram, and the role that systemic factors play in shaping the available alternatives from which individuals acting within institutions choose. The analysis stemming from Milgram’s experiments suggests not simply that individuals temporarily abdicate their moral agency on occasion, but that there is an erosion of agency within organizations. The (...) point about the erosion of agency is deepened in the discussion of a case study which illustrates the difficulty of identifying even the bare “ownership” of actions within organizations. While this is the case, explicating these reasons suggests that both individual actors and firms can bear ethical responsibility within organizational contexts. As part of the effort to present the whole picture, business ethics courses should introduce students to the relevant insights from social psychology and human factors research. (shrink)

The substituted judgement principle is often recommended as a means of promoting the self-determination of an incompetent individual when proxy decision makers are faced with having to make decisions about health care. This article represents a critical ethical analysis of this decision-making principle and describes practical impediments that serve to undermine its fundamental purpose. These impediments predominantly stem from the informality associated with the application of the substituted judgement principle. It is recommended that the principles upon which decisions are made (...) about health care for another person should be transparent to all those involved in the process. Furthermore, the substituted judgement principle requires greater rigour in its practical application than currently tends to be the case. It may be that this principle should be subsumed as a component of advance directives in order that it fulfils its aim of serving to respect the self-determination of incompetent individuals. (shrink)

Experiences of moral distress encountered in psychiatric practice were explored in a hermeneutic phenomenological study. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychiatrists describe struggling ‘to do the right thing’ for individual patients within a societal system that places unrealistic demands on psychiatric expertise. Certainty on the part of the psychiatrist is an expectation when judgments of dangerousness and/or the need for coercive treatments are made. This assumption, however, ignores the uncertainty and (...) complexity of reality. Society entrusts psychiatrists to care for and treat those among its most vulnerable members: persons deemed to have a severely diminished capacity for autonomy due to a mental disorder. Simultaneously, psychiatrists are held accountable by society for the protection of the public. Moral distress arose for psychiatrists in their efforts to fulfill both roles. They described an ‘outsider/insider’ status and the ways in which they attempted to cope with moral distress. (shrink)

Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...) only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim. (shrink)

Relatively few authors attempt to assess individuals’ moral responsibility for collective action within organizations. I draw on fairly technical recent work by Seamus Miller, Christopher Kutz, and Tracy Isaacs in the field of collective responsibility to see what normative lessons can be prepared for people considering entry into large hierarchical, compartmentalized organizations like businesses or the military. I will defend a view shared by Isaacs that group members’ responsibility for collective action depends on intentions to contribute to particular collective actions, (...) against Miller and Kutz’s more inculpating standards. Miller and Kutz fail to achieve their goal of articulating a variable standard for measuring individual responsibility within organizations, for reasons suggesting we might not be able to do better with their theoretical commitments than a threshold warning for all potential entrants to be wary of the groups they enter. Isaacs sketches an approach that is more successful at creating a variable standard for assessing high echelon actors; I build on and refine her theory to argue that organization members can be held responsible for their unique interpretations of the organization mission and unique contributions to their role duties. High echelon actors may share personal responsibility for their subordinates’ behavior when they have created the conditions for those actions through their unique orders. (shrink)

Scholars have shown renewed interest in the construct of courage. Recent studies have explored its theoretical underpinnings and measurement. Yet courage is generally discussed in its broad form to include physical, psychological, and moral features. To understand a more practical form of moral courage, research is needed to uncover how ethical challenges are effectively managed in organizational settings. We argue that professional moral courage (PMC) is a managerial competency. To describe it and derive items for scale development, we studied managers (...) in the U.S. military and examined prior work on moral courage. Two methods were used to measure PMC producing a five dimensional scale that organized under a single second-order factor, which we termed overall PMC. The five dimensions are moral agency, multiple values, endurance of threats, going beyond compliance, and moral goals. Convergent and discriminant validity are analyzed by use of confirmatory factor analysis procedures. We conclude by presenting a framework for proactive organizational ethics, which reflects how to support PMC as a management practice. (shrink)

Abstract:Why does it matter that every negative thought you have had about car salespeople, they have likely had about you? The answer to this question opens up the distinctive challenges, and opportunities, facing business ethics. Those challenges and opportunities emerge from the significant bearing organizational reality has upon individuals’ conduct. As we consider how to assign responsibility for misconduct; how to provide guidance to organizational actors about what they ought to do; and how to develop responsive ethical theory, we need (...) to take psychological and social forces into account. Organizations shape human behavior in ways that pose unavoidable questions about responsibility, practical guidance, and the enterprise of business ethics itself. Adopting the agents’ perspective suggests that business ethics can take a leading role in addressing these vexing questions that confront ethical inquiry and social science more broadly. (shrink)

Artificial persons are those who speak and act for others. Nurses speak and act for patients as well as for physicians and institutions, or, more aptly, institutionalized medicine. Yet, acting for institutionalized medicine can be harmful to nurses, due to the psychological experience of moral distress and the loss of integrity of their practice. This paper illustrates the harm to nurses as expressed in narratives of their practice, and suggests some initial steps we might take in resisting the artificial personhood (...) imposed by institutionalized medicine. (shrink)

Recently, religious organisations, governments and public institutions have begun to offer apologies for historical wrongs. Can they legitimately do so? Departing from the tendency, Professor Hubert Markl, President of the Max Planck Society, has offered strong reasons for not apologising for the crimes of medical scientists who experimented on human subjects during the Nazi era. He argues that only the perpetrators can meaningfully apologise. Markl’'s position is considered and rejected in favour of the view that apologies by proxy for historical (...) wrongs are justifiable and should be made by institutions that have the authority to do so. (shrink)

Based on individual and focus-group interviews, this article describes how social workers in a variety of settings and geographical areas within Ontario approached ethical issues in their daily practices. Two primary approaches to professional ethics emerge from the data: principle based and virtue based, reflecting the orientation of groups we label believers and skeptics, respectively. The code of ethics appears to be the fulcrum from which our participants swing. The believers show faith in the code of ethics and the skeptics (...) are dubious that codes are necessarily in the best interests of clients. The article describes the thinking behind the actions of the believers and skeptics and explores possibilities for future practice and research with respect to decision-making regarding ethical issues in the social work profession. (shrink)