This study analyses for the first time whether and when moral distress may be related to work-family conflict and burnout. Additionally, this study examines whether resilience and positive refocusing might protect healthcare professionals from the negative effects of moral distress. A total of 153 Italian healthcare professionals completed self-report questionnaires. Simple and moderated mediation models revealed that moral distress was positively related to burnout, directly and indirectly, as mediated by work-family conflict. Highly resilient professionals experienced low work-family conflict, regardless of (...) moral distress levels. Moreover, professionals who frequently used positive refocusing were less vulnerable to burnout following moral distress. (shrink)

There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has (...) the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. (shrink)

This study examines a mediated model of ethical leadership on ethical climate, turnover intention, and affective commitment. It is suggested that managers are role models in their organizations. Specifically, through ethical leadership behavior, managers can influence perceptions of ethical climate, which in turn will positively influence organizational members’ turnover intention, and affective commitment. The results indicate that ethical leadership has both direct and indirect effect on affective commitment and turnover intention. The indirect effect of ethical leadership involves shaping perceptions of (...) ethical climate, which in turn, engenders greater affective organizational commitment and less turnover intention. (shrink)

To advance current knowledge on ethical decision-making in organizations, we integrate two perspectives that have thus far developed independently: the organizational identification perspective and the ethical climate perspective. We illustrate the interaction between these perspectives in two studies, in which we presented participants with moral business dilemmas. Specifically, we found that organizational identification increased moral decision-making only when the organization’s climate was perceived to be ethical. In addition, we disentangle this effect in Study 2 from participants’ moral identity. We argue (...) that the interactive influence of organizational identification and ethical climate, rather than the independent influence of either of these perspectives, is crucial for understanding moral decision-making in organizations. (shrink)

Previous work suggests that moral intensity and the perceived importance of an ethical issue can influence individual ethical decision making. However, prior research has not explored how the various dimensions of moral intensity might differentially affect PIE, or how moral intensity might function together with (or in the presence of) PIE to influence ethical decision making. In addition, prior work has also not adequately investigated how the operational context of an organization, which may embody conditions or practices that create barriers (...) to ethical decision making, may differ from other functional areas of an organization. Consequently, this study investigated the relationships among moral intensity, perceived ethical issue importance, and three stages of the ethical reasoning process: recognition of an ethical issue, ethical judgment, and ethical intention. Using an internet-based, self-report survey containing two operations management scenarios and various ethics measures, information was collected from business professionals working for a Midwestern financial services organization. The hierarchical regression results indicated that some dimensions of moral intensity were positively related to PIE, ethical issue recognition, and ethical judgment, and that PIE was associated with increased ethical issue recognition and ethical judgment. The steps of ethical reasoning were also positively interrelated. (shrink)

Senior managers are important to the successful management of ethics in organizations. Therefore, their perceptions of organizational ethics are important. In this study, we propose that senior managers are likely to have a more positive perception of organizational ethics than lower level employees do largely because of their managerial role and their corresponding identification with the organization and need to protect the organization’s image as well as their own identity. By contrast, lower level employees are more likely to be cynical (...) about the organization’s ethics. In order to compare senior managers’ and lower level employees’ perceptions of ethics in the organization, we surveyed randomly selected senior managers and lower level employees in three firms. We found that perceptions of ethics in the organization differed predictably across levels, with senior managers’ perceptions being significantly more positive and lower level employees’ perceptions being more negative. Implications for practice and research are discussed. (shrink)

The literature on conscience in medicine has paid little attention to what is meant by the word ‘conscience.’ This article distinguishes between retrospective and prospective conscience, distinguishes synderesis from conscience, and argues against intuitionist views of conscience. Conscience is defined as having two interrelated parts: (1) a commitment to morality itself; to acting and choosing morally according to the best of one’s ability, and (2) the activity of judging that an act one has done or about which one is deliberating (...) would violate that commitment. Tolerance is defined as mutual respect for conscience. A set of boundary conditions for justifiable respect for conscientious objection in medicine is proposed. (shrink)

Next SectionBackground: Physicians face ethical difficulties daily, yet they seek ethics consultation infrequently. To date, no systematic data have been collected on the strategies they use to resolve such difficulties when they do so without the help of ethics consultation. Thus, our understanding of ethical decision making in day to day medical practice is poor. We report findings from the qualitative analysis of 310 ethically difficult situations described to us by physicians who encountered them in their practice. When facing such (...) situations, the physicians sought to avoid conflict, obtain assistance, and protect the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These goals could conflict with each other, or with ethical goals, in problematic ways. Being aware of these potentially conflicting goals may help physicians to resolve ethical difficulties more effectively. This awareness should also contribute to informing the practice of ethics consultation. Objective: To identify strategies used by physicians in dealing with ethical difficulties in their practice. Design, setting, and participants: National survey of internists, oncologists, and intensive care specialists by computer assisted telephone interviews (n = 344, response rate = 64%). As part of this survey, we asked physicians to tell us about a recent ethical dilemma they had encountered in their medical practice. Transcripts of their open-ended responses were analysed using coding and analytical elements of the grounded theory approach. Main measurements: Strategies and approaches reported by respondents as part of their account of a recent ethical difficulty they had encountered in their practice. Results: When faced with ethical difficulties, the physicians avoided conflict and looked for assistance, which contributed to protecting, or attempting to protect, the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These efforts sometimes reinforced ethical goals, such as following patients’ wishes or their best interests, but they sometimes competed with them. The goals of avoiding conflict, obtaining assistance, and protecting the respondent’s integrity and that of the group of decision makers could also compete with each other. Conclusion: In resolving ethical difficulties in medical practice, internists entertained competing goals that they did not always successfully achieve. Additionally, the means employed were not always the most likely to achieve those aims. Understanding these aspects of ethical decision making in medical practice is important both for physicians themselves as they struggle with ethical difficulties and for the ethics consultants who wish to help them in this process. (shrink)

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

The spread and publicity given to questionable practices in the corporate world during the last two decades has fostered an increasing interest about the importance of ethical work for organizations, practitioners, scholars and, last but not least, the wider public. Relying on the Social Identity Approach, we suggest that the effects of different ethical climates on employee behaviors are driven by affective identification with the organization and, in parallel, by cognitive moral (dis)engagement. We compared the effects of two particular ethical (...) climates derived from the literature: An ethical organizational climate of self-interest, and an ethical organizational climate of friendship. Three hundred seventy-six workers completed measures of Ethical Climate, Organizational Identification, Moral Disengagement, Organizational Citizenship Behaviors, and Counterproductive Work Behaviors. Structural equation modelling confirmed that the two ethical climates considered were independently related to organizational identification and moral disengagement. These, in turn, mediated the effects of ethical climates on Organizational Citizenship Behaviors and Counterproductive Work Behaviors. We discuss results in light of the social identity approach, and present some practical implications of our findings. (shrink)

Action research is combined research and practical action where the researcher joins with and acts with practitioners to help improve practice and theory building. Action research can be a form of Aristotelian critical, ethical praxis that developmentally changes the action researcher and the external world. Bernstein’s and Eikeland’s interpretations of Aristotelian ethics praxis are considered. The Argyris et al. “action-science” and the van de Ven “engaged scholarship” forms of action research with their differently nuanced interpretations of Aristotelian philosophy as foundations (...) for action research are considered and compared as examples of action research as an ethics praxis method with respect to a key similarity with respect to joining of critical ethics and actionable knowledge; another key similarity with respect to action research practice that can developmentally change the action researcher and the external world; and a key difference with respect to academic literature versus practitioner-based theory building is also considered. Examples in the cases of the political economist and action researcher, Hirschmann’s “Exit,Voice, Loyalty” approach and Greenleaf’s “Servant Leadership” approach to action research as forms of Aristotelian critical, ethical praxis are analyzed. (shrink)

It is now common in health care for a diverse range of professions and disciplines to work together in regular and close contact. Thus, there are now calls in the literature for research that documents insights on the ethical dimension of multidisciplinary relationships. Recent Australian research has responded to this call by examining how a multidisciplinary team of health professionals define and operationalize the notion of ethics in an acute ward hospital setting. This article provides findings from the research study (...) that indicate that, although there is a shared conceptualization of ethics as "patient-centered care", there can be times of conflict and tension in determining what is best for the patient. The discussion begins to build an understanding of how a multidisciplinary mix of health professionals responds to ethical conflict and tension. The authors' hope and expectation is that, by keeping the research focus on what health professionals in a multidisciplinary team (MDT) actually do, rather than exclusively on how they philosophically think about ethical dilemmas, the insights can be translated into practical strategies that can be utilized to strengthen the process of ethical decision making within the health care system. (shrink)

To advance current knowledge on ethical decision-making in organizations, we integrate two perspectives that have thus far developed independently: the organizational identification perspective and the ethical climate perspective. We illustrate the interaction between these perspectives in two studies, in which we presented participants with moral business dilemmas. Specifically, we found that organizational identification increased moral decision-making only when the organization’s climate was perceived to be ethical. In addition, we disentangle this effect in Study 2 from participants’ moral identity. We argue (...) that the interactive influence of organizational identification and ethical climate, rather than the independent influence of either of these perspectives, is crucial for understanding moral decision-making in organizations. (shrink)

The concept of moral identity based on virtue ethics has become an issue of considerable import in explaining moral behavior. This attempt to offer adequate explanations of the full range of morally relevant human behavior inevitably provokes boundary issues between ethics and moral psychology. In terms of the relationship between the two disciplines, some argue for ?naturalized (or psychologized) morality,? whereas, on the other hand, others insist on ?moralized psychology.? This article investigates the relationship between virtue ethics and moral identity (...) based on previous research on the relationship between ethics and moral psychology. This article especially attempts to show that meaningful links between the two concepts possible by using theoretical frameworks constructed by the most influential philosophers of science such as Kuhn and Lakatos. (shrink)

Arguing that psychology and business ethics are best brought together through a multi-level, broad-based agenda, this essay articulates a vision of psychology and business ethics to frame a future research agenda. The essay draws upon work published in JBE, but also identifies gaps where published research is needed, to build upon psychological conceptions of business ethics. Psychological concepts, notably, are not restricted to phenomena “in the head”, but are discussed at the intra-psychic, relational, and contextual levels of analysis. On the (...) basis of this presentation, I discuss future directions for development in psychology and business ethics, including but not limited to studies of personality, emotion, decision making, motivation, and the biological bases of psychology and business ethics. An inclusive approach to these and related areas, it is argued, will both bring about depth of understanding on the psychological bases of business ethics, and allow dialogue across disciplinary areas within JBE. (shrink)

This qualitative study explores how business leaders narrate their personal ways of recognizing, reasoning, and resolving moral conflicts and what these stories reveal about their moral identity processes within organizational contexts. Based on interviews with 25 business leaders, 4 moral identity statuses were identified: achievement, moratorium, foreclosure, and diffusion. The moral identity statuses were based on how leaders approached and interpreted moral conflicts and what the influence of the organizational context was in their moral decision-making processes. Some remained steadfast in (...) adhering to their previous value commitments, while others tried to avoid taking any clear moral standpoint. Still others experienced moral conflicts as disequilibrating events that triggered reflective processes and developmental cycles of moral identity change. These moral identity statuses hold implications for facilitating moral identity development among business leaders in the context of work. (shrink)

The role and ethics of professionals in business and economics have been questioned, especially after the financial crisis of 2008. Some suggest a reorientation using concepts such as craftsmanship. In this article, I will explore professional practices within the context of behavioural theory and business ethics. I suggest that scholars of behavioural theory need a strategy to deal with normative questions to meet their ambition of practical relevance. Evidence-based management (EBMgt), a recent behavioural approach, may assist business ethics scholars in (...) understanding how professionals infer ‘evidence’ to make decisions. For a professional, ethical issues are an integral part of decision-making at critical moments. As reflective practitioners, they develop insights related to ethical concerns when collecting and assessing evidence within decision-making processes. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

This study examines factors impacting ethical behavior of 103 hospital nurses. The level of emotional intelligence and ethical behavior of peers had a significant impact on ethical behavior of nurses. Independence climate had a significant impact on ethical behavior of nurses. Other ethical climate types such as professional, caring, rules, instrumental, and efficiency did not impact ethical behavior of respondents. Implications of this study for researchers and practitioners are discussed.