Iranian Journal of Medical Ethics and History of Medicine

To consider ourselves as "lesser evil" and to consider ourselves "holier" are two different categories in evaluating moral action, that its motivation and success rate vary in each other. After reviewing the justification mechanisms in four real situations involving altruistic act, the present study seeks to examine the validity of the current models of the temporality of justification for moral disengagement in terms of inclusion. In addition to verify the common models for categorizing justifications in two situations as "less evil" and as "holier", this examination aims to clarify the moral behaviors of the moral actor and facilitate ethical judgment in a more analytical space. The participants of the study were 71 undergraduate and postgraduate students at Shiraz University selected in convenience method. In order to evaluate how respondents respond to situations which require altruistic action, four realistic situations of altruistic action were designed. The responses and justifications presented by those who didn’t cooperate with the altruistic plan were subjected to direct content analysis. In the face of the altruistic plans of those who refuse, their justifications were in accordance with some of the mechanisms mentioned in the background. However, there were two categories of justification that were not understandable with the categories in the literature. These two categories are named according to their core themes, self-oriented justification, and other-oriented justification. The results implied confirmation of Klein and Epleis’s distinction of motivation toward lesser evil and holier.
 

Organizational ethics in healthcare literature encompasses a set of complex and interrelated topics. It is regarded as the frontier of medical ethics or the next stage in the evolution of bioethics. To effectively address organizational ethical issues within healthcare organizations, it is crucial to understand both the similarities and differences between competing concepts. Moreover, the presence of financial and contractual concerns often makes it challenging to motivate managers to enhance the ethical climate of their organizations. This study aims to develop a deeper and more comprehensive understanding of organizational ethics in the healthcare system. This review study involved a comprehensive search of the literature on healthcare system ethics, utilizing the following databases: PubMed, Scopus, Web of Science, and CINAHL. Additionally, grey literature from published books on Healthcare Organization Ethics and websites of organizations such as JCAHO and VBN were also included. The search strategy employed a combination of keywords such as 'health ethics,' 'organizational ethics,' 'health organizations,' 'ethical decision-making,' 'manager motivation,' and 'CEO incentives.' Only English-language sources with accessible full-texts were considered. All search results were reviewed, and duplicates were removed. This study offers a comprehensive overview of the existing literature on organizational ethics in healthcare, providing a detailed map of key texts in the field.