“There is total silence here” Ethical competence and inter-organizational learning in healthcare governance
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 28 November 2019
Issue publication date: 6 March 2020
Abstract
Purpose
The purpose of this paper is to analyse ethical competence related to healthcare governance and management tasks at the county/regional level in Sweden. The paper also discusses conditions that support or constrain the development and application of such competence.
Design/methodology/approach
The study is based on original qualitative data from 13 interviews and 6 meeting observations. Three key groups of actors were included: politicians, civil servants and CEOs in publicly financed health-provider organizations. An abductive analysis was carried out by a stepwise method guided by thematic research questions.
Findings
The informants viewed themselves as having a high degree of ethical responsibility for healthcare practice. However, they did not integrate ethical reflection and dialogue into their work decisions (e.g. regarding budgets, reforms and care agreements). The current organization, control systems and underlying business principles, along with the individuals’ understanding of their own and others’ roles, tended to constrain the development and use of ethical competence.
Practical implications
Qualities of an appropriate ethical competence related to healthcare governance and management, and conditions to develop and use such competence, are suggested.
Originality/value
Hardly any empirical research has examined ethical competence related to healthcare governance and management tasks. The paper integrates ethics and theories on learning in organizations and contributes knowledge about ethical competence and the conditions necessary to develop and practise ethical competence in an organizational and inter-organizational context.
Keywords
Acknowledgements
This paper builds on research financed by the AFA Insurance (130087). Thanks to the reviewers for encouraging and helpful comments on the manuscript.
Citation
Falkenström, E. and Höglund, A.T. (2020), "“There is total silence here” Ethical competence and inter-organizational learning in healthcare governance", Journal of Health Organization and Management, Vol. 34 No. 1, pp. 53-70. https://doi.org/10.1108/JHOM-05-2019-0130
Publisher
:Emerald Publishing Limited
Copyright © 2019, Emerald Publishing Limited