In recent years, organisational theorists have been interested in the tensions faced by healthcare organisations. In this paper, these tensions are examined using the virtue approach to ethics of Alasdair MacIntyre. It is argued that although MacIntyre's framework shares many concerns with organisational studies, it supplements the analysis with a focus on moral content and evaluation. By providing moral evaluation of the stories told in organisations, an ethical analysis compels action on a basis that organisational studies does not. Nevertheless, it (...) is the analysis of stories in organisation studies that provides the tools for taking action. The analysis presented here provides an example of how ethics and organisational studies can be brought together to provide a stronger analysis of organisational phenomena. Indeed, it provides support for Nielsen's position that organisational theory and ethics are co‐dependent and suggests that greater attention should be paid to ethical concepts in the study of organisational phenomena. (shrink)

The ongoing global economic and financial crisis has exposed the risks of considering market and business organizations only as instruments for creating economic wealth while paying little heed to their role in ethics and values. Catholic Social Teaching (CST) could provide a useful contribution in rethinking the role of values in business organizations and markets because CST puts forward an anthropological view that involves thinking of the marketplace as a community of persons with the aim of participating in the Common (...) Good (CG) of society. In the light of the CST tradition, and in particular Caritas in Veritate , this article investigates the thinking of some of the historical scholars of the Italian Economia Aziendale ( EA ), by focusing on the concept of azienda , in order to reinterpret in a more humanistic way the role of business organizations in society. By linking CST and EA , the dichotomy between for-profit and not-for-profit organizations and the stereotype of the so-called business amorality that has, for a long time, driven business managers can be transcended. The conclusions imply a forward-looking application of the ethical concepts embedded in the Italian science of EA. (shrink)

The current debate that surrounds the issue of patient rights and the transformation of health care, social insurance, and reimbursement systems has put the topic of patient responsibility on both the public and health care sectors' agenda. This climate of debate and transition provides an ideal time to rethink patient responsibilities, together with their underlying rationale, and to determine if they are properly represented when being called `patient' responsibilities. In this article we analyze the various types of patient responsibilities, identify (...) the underlying motivations behind their creation, and conclude upon their sensibleness and merit. The range of patient responsibilities that have been proposed and implemented can be reclassified and placed into one of four groups, which are more accurate descriptors of the nature of these responsibilities. We suggest that, within the framework of a free-market system, where health care services are provided based on the ability to pay for them, none of these can properly be justified as a patient responsibility. (shrink)

This paper focuses much-needed attention on the ethical nature of customer relationship management (CRM) strategies in organisations. The research uses an in-depth case study to reflect on the design, implementation and use of ‘best practice’ associated with CRM. We argue that conventional CRM philosophy is based on a fairly narrow construct that fails to consider ethical issues appropriately. We highlight why ethical considerations are important when organisations use CRM and how a more holistic approach incorporating some of Alasdair MacIntyre's ideas (...) on virtue ethics could be relevant. (shrink)

Changes in modern societies originate the perception that ethical behaviour is essential in organization’s practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of social responsibility. Recently the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health has addressed this concept of social responsibility in the context of health care delivery suggesting a new paradigm in hospital governance. The objective of this paper (...) is to address the issue of corporate social responsibility in health care, namely in the hospital setting, emphasising the special governance arrangements of such complex organisations and to evaluate if new models of hospital management (entrepreneurism) will need robust mechanisms of corporate governance to fulfil its social responsiveness. The scope of this responsible behaviour requires hospitals to fulfil its social and market objectives, in accordance to the law and general ethical standards. Social responsibility includes aspects like abstention of harm to the environment or the protection of the interests of all the stakeholders enrolled in the deliverance of health care. In conclusion, adequate corporate governance and corporate strategy are the gold standard of social responsibility. In a competitive market hospital governance will be optimised if the organization culture is reframed to meet stakeholders’ demands for unequivocal assurances on ethical behaviour. Health care organizations should abide to this new governance approach that is to create organisation value through performance, conformance and responsibility. (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)

The theory of the social responsibility of the firm oscillates between two extremes: one that reduces the firm's responsibility to the obtainment of (the greatest possible) profit for its shareholders, and another that extends the firm's responsibility to include a wide range of actors with an interest or "stake" in the firm. The stakeholder theory of the social responsibility of business is more appealing from an ethical point of view, and yet it lacks a solid foundation that would be acceptable (...) to a variety of schools of thought.In this paper I argue that the stakeholder theory could be founded on the concept of the common good. First, I explain the foundations of the theory of the common good, the concept itself, how it relates to the individual good, and its role in the firm. Following that, I explain how the theory of the common good could be applied to the stakeholder theory. Finally, I draw some conclusions. (shrink)

The empirical findings in Collins and Porras'' study of visionary companies, Built to Last, and the normative claims about the purpose of the business firm in Centesimus Annus are found to be complementary in understanding the purpose of the business firm. A summary of the methodology and findings of Built to Lastand a short overview of Catholic Social Teaching are provided. It is shown that Centesimus Annus'' claim that the purpose of the firm is broader than just profit is consistent (...) with Collins and Porras empirical finding that firms which set a broader objective tend to be more successful than those which pursue only the maximization of profits. It is noted however that a related finding in Collins and Porras, namely that the content of the firm''s objective is not as important as internalizing some objective beyond just profit maximization, can lead to ethical myopia. Two examples are provided of this: the Walt Disney Company and Philip Morris. Centesimus Annus offers a way to expose such myopia, by providing guidance as to what the purpose of the firm is, and therefore as to what kinds of objectives are appropriate to the firm. (shrink)

“The NHS may not, on a tight definition, be a business, but it has an obligation to its financial stakeholders , and this implies an ethical obligation to be business‐like. This means it must be as well‐managed as it is well‐meaning.” The author is Chairman of St George's Healthcare NHS Trust. Until 1988 she was Head of the Department of Politics at Queen Mary and Westfield College, University of London, where she is now Visiting Professor. She is a non‐executive director (...) of Norwich Union and of the HMV Group and her most recent book is Business Ethics at Work, Cambridge University Press, 1995. (shrink)

“The NHS may not, on a tight definition, be a business, but it has an obligation to its financial stakeholders, and this implies an ethical obligation to be business‐like. This means it must be as well‐managed as it is well‐meaning.” The author is Chairman of St George's Healthcare NHS Trust. Until 1988 she was Head of the Department of Politics at Queen Mary and Westfield College, University of London, where she is now Visiting Professor. She is a non‐executive director of (...) Norwich Union and of the HMV Group and her most recent book is Business Ethics at Work, Cambridge University Press, 1995. (shrink)

The objective of this paper is to provide an overview of corporate social responsibility (CSR) in Greece and present the challenges that need to be met in order to further promote socially responsible business behaviour in the domestic economy. This is the first attempt to provide a systematic analysis of CSR in Greece and adds to the existing pool of knowledge of CSR embeddedness in countries where CSR awareness is still rather low, a literature field that is still quite limited. (...) Drawing from prior literature, the paper is built around three basic questions in relation to the Greek context: how is CSR perceived by Greek business professionals? How is CSR practised in Greece? And which issues evident in the modern domestic environment act as underlying barriers to the broader dissemination of CSR in Greece? The extant empirical work suggests that, while CSR in Greece appears to be developing, there is still scope for improvement and further diffusion of relevant practices. While some of the patterns shaping CSR in Greece have been analysed, much work still remains to be carried out in extending and deepening our knowledge in this part of Europe. (shrink)

The objective of this paper is to provide an overview of corporate social responsibility (CSR) in Greece and present the challenges that need to be met in order to further promote socially responsible business behaviour in the domestic economy. This is the first attempt to provide a systematic analysis of CSR in Greece and adds to the existing pool of knowledge of CSR embeddedness in countries where CSR awareness is still rather low, a literature field that is still quite limited. (...) Drawing from prior literature, the paper is built around three basic questions in relation to the Greek context: how is CSR perceived by Greek business professionals? How is CSR practised in Greece? And which issues evident in the modern domestic environment act as underlying barriers to the broader dissemination of CSR in Greece? The extant empirical work suggests that, while CSR in Greece appears to be developing, there is still scope for improvement and further diffusion of relevant practices. While some of the patterns shaping CSR in Greece have been analysed, much work still remains to be carried out in extending and deepening our knowledge in this part of Europe. (shrink)

Tasubinsa is a "Special Employment and Occupational Center" constituted in accordance with Spanish Law where 90% of the workers have mental, sensorial or physical impairments of at least 30%. Its positive experience of more than 15 years provides entirely different responses from mainstream neoclassical theory (transaction cost theory, agency theory, and shareholder theory) to basic questions such as "What is a firm?", "What is its purpose?", "Who owns a firm?", and "What do a firm's owners seek?". The article discusses how (...) these different premises give rise to a distinctive corporate culture centered on the handicapped person. (shrink)

Until recently, business issues in healthcare organizations were relatively insulated from clinical issues, for several reasons. The hospital at earlier stages of its development operated on a combination of charitable and equitable premises, allowing for providing care to be separated from financial support. Physicians, who were primarily responsible for clinical care, constituted an independent power nexus within the hospital and were governed by their own professional codes of ethics. In exchange for a great deal of control over their conditions of (...) practice, they took almost complete responsibility for patient care. Thus clinical and professional ethics could to some extent be compartmentalized from the business issues—a much easier feat when, as in much of the last few decades, virtually all care was reimbursed from some source or other. In addition, many HCOs were not categorized or treated as businesses, although of course they were presumed to be governed by the same expectation for good management as any other organization. (shrink)

The article starts by arguing that seeing the firm as a mere nexus of contracts or as an abstract entity where different stakeholder interests concur is insufficient for a “humanistic business ethos”, which entails a complete view of the human being. It seems more appropriate to understand the firm as a human community, a concept which can be found in several sources, including managerial literature, business ethics scholars, and Catholic Social Teaching. In addition, there are also philosophical grounds that support (...) the idea of business as a human community. Extending this concept, and drawing from some Phenomenological-Personalist philosophers, we propose that the firm should be seen as a particular “community of persons” oriented to providing goods and services efficiently and profitably. Being a “community of persons” emphasizes both individuals and the whole, and makes explicit the uniqueness, conscience, free will, dignity, and openness to human flourishing. This requires appropriate communication about and participation in matters which affect people’s life, and makes it essential to cooperate for the common good of the business firm and the society. (shrink)

Some virtue ethicists are reluctant to consider principles and standards in business ethics. However, this is problematic. This paper argues that realistic Personalism can be integrated into virtue-based business ethics, giving it a more complete base. More specifically, two principles are proposed: the Personalist Principle (PP) and the Common Good Principle (CGP). The PP includes the Golden Rule and makes explicit the duty of respect, benevolence, and care for people, emphasizing human dignity and the innate rights of every human being. (...) The CGP entails cooperation to promote conditions which enhance the opportunity for the human flourishing of all people within a community. Both principles have practical implications for business ethics. (shrink)

The inevitable need for rationing of healthcare has apparently presented the medical profession with the dilemma of choosing the lesser of two evils. Physicians appear to be obliged to adopt either an implausible version of traditional professional ethics or an equally problematic ethics of bedside rationing. The former requires unrestricted advocacy of patients but prompts distrust, moral hazard and unfairness. The latter commits physicians to rationing at the bedside; but it is bound to introduce unfair inequalities among patients and lack (...) of political accountability towards citizens. In this paper I shall argue that this dilemma is false, since a third intermediate alternative exists. This alternative, which I term 'administrative gatekeeping', makes it possible for physicians to be involved in rationing while at the same time being genuine advocates of their patients. According to this ideal, physicians are required to follow fair rules of rationing adopted at higher organizational levels within healthcare systems. At the same time, however, they are prohibited from including considerations of cost in their clinical decisions. (shrink)

We analyse solidarity as a mixture of social justice on the onehand and a set of cultural values and ascriptions on the otherhand. The latter defines the relevant sense of belonging togetherin a society. From a short analysis of the early stages of theDutch welfare state, we conclude that social responsibility wasoriginally based in religious and political associations. In theheyday of the welfare state, institutions such as sick funds,hospitals or nursing homes became financed collectively entirelyand became accessible to people of (...) all denominations. Solidaritywas transformed in a more general category, related to the statusof Dutch citizenship. Responsibility was transformed tocollective responsibility.Financial pressures on the Welfare State have resulted in adebate on choices in health care and in a number of systemreforms, so far relatively small. In the surrounding discourse,justice was linked to private responsibility. Both fromgovernment officials and from participants in the societaldebate, moralistic overtones could be heard concerning the threatof overburdening of the health care system by citizens.In this paper, we develop a concept of reflexive solidarity thatlinks elements of social justice to conceptualisations ofresponsibility that address policy makers and health careinstitutions as well as citizens, in their role of carereceivers. A short analysis of the phenomenon of personal budgetsin care services should prove that our concept of reflexivesolidarity is not empty. Linked to, but beyond the concept ofjustice, issues of social responsibility can be addressed withoutmoralistic overtones. (shrink)

A masterful series of interviews with Levinas, conducted by French philosopher Philippe Nemo, which provides a succinct presentation of Levinas's philosophy.