Business ethics, organization ethics, and systems ethics for health care

Patricia Werhane

pp. 205-227

in: David Bevan, Regina W. Wolfe (eds), Systems thinking and moral imagination, Berlin, Springer, 2019

Abstract

In this article Werhane explores the chaotic system of public and private health provision in the United States, and the complexity inherent in mixing managerial and medical priorities across a range of interlocking professional and commercial interests. Almost all health care professionals work in organizations, and these organizations are often managed by managerial specialists rather than health care specialists. Thus, the relationships between professional managers and health care professionals are constitutionally complex, not to mention frequently acrimonious. Such confrontations lead to moral stress. Unless they self-insure their patients, who then will have to interact personally with the insurers, health care organizations themselves have to interact with professional insurers as well as national and state Medicare and Medicaid programs, all of which operate with varying, complex and changing regulations. In addition, health care organizations interact with suppliers, non-health care workers and, most importantly, patients, some of whom may be uninsured. Bracketing these contextual arrangements tends to simplify the complex challenges of most health care providers, suppliers or insurers. A systems approach to the context helps individuals, patients, professionals, managers and organizations to imagine and think through these complexities to get a clearer picture of what is at stake. Moral imagination is, thus, useful as a tool in approaching these kinds of frequently problematic analyses.Original publication: Werhane, Patricia H. "Business Ethics, Organization Ethics, and Systems Ethics for Health Care." In The Blackwell Guide to Business Ethics, edited by Norman Bowie, 289–312. Boston: Blackwell's, 2002. ©2002 Reprinted with permission.