What are the moral challenges that confront doctors as they manage healthcare institutions? How do we build trust in medical organisations? How do we conceptualize moral action? Based on accounts given by senior doctors from organisations throughout the UK, this book discusses the issues medical leaders find most troubling and identifies the moral tensions they face. Moral Leadership in Medicine examines in detail how doctors protect patients' interests, implement morally controversial change, manage colleagues in difficulty and rebuild trust after serious medical harm. The book discusses how leaders develop moral narratives to make sense of these situations, how they behave while balancing conflicting moral goals and how they influence those around them to do the right thing in difficult circumstances. Based on empirical ethical analysis, this volume is essential reading for clinicians in leadership roles and students and academics in the fields of healthcare management, medical law and healthcare ethics.
- Based on personal interviews, this book will enable readers to learn from the experience of medical leaders
- Proposes new ways of developing collective moral capability
- Describing the behaviours of medical leaders, it will aid understanding of significant unspoken expectations
Advance praise:'Dr Shale's book is an outstanding contribution to medical ethics. Its combination of theoretical reflection and empirical research is robust and insightful. I believe that her examination of the ways personal, organizational and situational ethics interact is profound and important for understanding real world healthcare. She writes with wit and grace. This is a superb book, which should be on the desk of anyone who thinks seriously about medical ethics and about the organisation of healthcare.'
Richard Ashcroft, Queen Mary, University of London
'This unique study will be of great value to those who have a leadership role at all levels in healthcare organisations. Dr Shale has drawn on the real experience of medical leaders to produce a genuinely useful framework for understanding the moral challenges that are regularly faced by both clinicians and managers. In doing so, she has opened the way for discussion about how we manage the value tensions at the heart of the business of healthcare, how we meet the moral needs of the patients and families we serve, and what it means to lead with integrity.'
Dr Adrian Bull, Medical Director, Queen Victoria Hospital NHS Foundation Trust
'Suzanne Shale has achieved a rare and impressive feat in combining theoretical rigour with empirical analysis in a way that make[s] her book uniquely valuable and insightful. This is a work that skilfully bridges the gap between the abstract and its application. It is an account that illustrates how moral questions and experiences are multi-layered and nuanced encompassing the systemic, organisational and personal. Dr Shale casts analytical light on areas of clinical management and leadership that have been overlooked within bioethics. This book is an original, scholarly and engaging work in which the author's thoughtful and wise perspective shines through on every page.'
Professor Deborah Bowman, St George's, University of London
Table of Contents
1. Why medicine needs moral leaders
2. Creating an organizational narrative
3. Understanding normative expectations in medical moral leadership
- Prologue to chapters four and five
4. Expressing fiduciary, bureaucratic and collegial propriety
5. Expressing inquisitorial and restorative propriety
- Epilogue to chapters four and five
6. Understanding organizational moral narrative
7. Moral leadership for ethical organizations
- Appendix 1. How the research was done
- Appendix 2. Accountability for clinical performance: individuals and organisations
- Appendix 3. A brief guide to commonly used ethical frameworks