Seeing the Forest Beyond the Trees: A Holistic Approach to Health-Care Organizational Ethics

Research on organizational ethics in healthcare has made some important steps over the past two decades in exploring how context impacts the medical act itself. However, aspects of the organizational context, such as the relation compliance-integrity, are still approached in a dichotomous manner, and this potentially impedes the development of the research field. This article steps back to take a more holistic view of organizational ethics and thus provides more explanatory power to the field. To that end, the article argues that compliance and integrity need to be seen as complementary approaches to organizational issues in healthcare. These approaches also respond to and mirror two contextual dimensions that require better alignment: the organizational informal culture and the formal structure. Both are necessary to adequately understand and embed ethics in healthcare organizations. To address these issues, the article uses normative insights from research in business ethics, such as the integrated model of ethics management or the concept of organizational practices, while arguing for closer collaboration in research between healthcare organizational ethics and business ethics.