The impact of hospital organization in the ethical act of hospital management

Objective: There are different levels of decision and clinical, administrative and management procedures in a hospital organization. The exercise of management and bioethics should be seen as an interconnected operation by anyone committed to an ethical conduct. This article is based on a larger study under a PhD in Bioethics and was conducted in 25 Portuguese hospitals. The objective of the article is to determine whether hospital organization is predictive of the ethical act of its managers. Methods: We have developed a correlational study using the Questionnaire of Ethicity in Hospital Management (QEHM). It was conducted with a sample of 421 professionals with management positions in Care Units/Services, Management Departments/Units, Boards of Directors of the National Health Service and hospitals connected to the Ministry of Health. The sample is also composed of different management models, representative of the Public, Private and Social sectors. Results: A significant association/correlation was discovered in the following dimensions: Accountability and quality, Ethical weighing and Costs and ethics within the management models; Ethical weighing and Ethical decision within the management level; Costs and ethics and Economical and ethical restriction within age. Conclusions: The ethical act of hospital managers, besides being associated with the hospital management model, is not independent of the managers’ age, being influenced by the organizational structure, particularly at management level. This means that hospital organization has an impact in the ethical act of hospital management. Given the correlational nature of the study and the current health sector reforms in Portugal, we suggest an observational study to examine the implications of the organization in the ethical act of managers and their impact on health care users, which was not included in this study.