Personal und Patienten in Einrichtungen organisierter Krankenbehandlung erfahren und bekunden vielfältige miserable Zustände dieser Organisationen. Einige „Miseren“ lassen sich im Rahmen einer Theorie institutioneller Pathologien als störende Auswirkungen der Aktivitäten und Strukturen von Organisationen des Politiksystems und des Wirtschaftssystems erklären. Deshalb können Klinische Ethik-Komitees solchen Miseren nicht wirksam begegnen oder sie sogar nicht einmal thematisieren. Organisationsethik kann sie thematisieren, aber ihnen nicht wirksam begegnen. Vorgeschlagen wird die Verstärkung von Organisationethik durch eine Theorie institutioneller Pathologie. Institutionspathologisch aufgeklärte, „klinische“ Organisationsethik kann helfen, (...) in Ethiktheorie und Praxis, etwa für Mitglieder von KEKs und Organisationethikberater, die Möglichkeiten der Beobachtung, Bewertung und ggf. Besserung von gestörten Verantwortungsverhältnissen erheblich zu erweitern. (shrink)

Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare (...) context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration. (shrink)

The question of corporate moral responsibility – whether corporate bodies can be held morally responsible for their actions – has been debated by a number of writers since the 1970s. This discussion is intended to add to that debate, and focuses for that purpose on our understanding of the organisation. Though the integrity of the organisation has been called into question by the postmodern view of organisations, that view does not necessarily rule out the attribution of corporate agency, any more (...) than the postmodern view of the person rules out the attribution of individual agency. The postmodern view is opposed to a reifying, metaphysical view of corporate agency, but a semantic view of corporate agency would seem to sit more comfortably with it. A bigger problem for the idea of corporate moral responsibility arises from the fact that in Kantian terms organisations are not ends in themselves. In that sense they are not like persons, and this must limit their autonomy, and their responsibility. This aspect of organisations also limits their punishability. For these reasons corporate moral responsibility must be seen as more limited than the responsibility of persons. (shrink)

There has been an ongoing appeal in the bioethics literature for a broader understanding and conceptual clarity of the phenomenon of moral distress. Several authors argue that greater conceptual cl...

Quantitative research has called attention to the burden associated with informal caregiving in home nursing arrangements. Less emphasis has been placed, however, on care recipients’ subjective feelings of being a burden and on caregivers’ willingness to carry the burden in home care. This article uses empirical material from semi‐structured interviews conducted with older people affected by multiple chronic conditions and in need of long‐term home care, and with informal and professional caregivers, as two groups of relevant others. The high burden (...) of home‐care arrangements is unanimously stressed by all three groups involved in the triangle of care. An empirical‐ethical investigation of what can be legitimately expected from family members and informal caregivers, informed by Frith's symbiotic empirical ethics approach, was undertaken. Key tenets from the special goods theory and nursing professionalism are used as analytical tools. The study concludes that the current situation may hinder professional development and can reinforce feelings of being a burden to relevant others. (shrink)

The concept of corporate social responsibility has been the subject of several academic contributions, but in the health sector the development of an interest in this subject is very recent. Although many practices in healthcare are already socially responsible, progressing from a series of socially responsible behaviours to a socially responsible organization entails a more consolidated awareness of the health sector’s mission and the needs of its participants. In this paper, we will review the different studies published that address the (...) relationship between the healthcare sector’s corporate responsibility and society, with the aims of individuating the prevailing foci that are emerging and categorizing the proposed contributions according to these foci: social responsibility and organization; social responsibility and social impact; social responsibility and competitiveness. Finally, the paper finishes with a personal definition of CSR and its correlated ethical roots. (shrink)