Skip to main navigation menu Skip to main content Skip to site footer
FrancoAngeli Journals

Saggi

No. 126 (2023)

Empirical research findings on ethics and leadership in the Italian healthcare system

DOI
https://doi.org/10.3280/mesa2023-126oa17280
Submitted
febbraio 15, 2024
Published
2024-04-24

Abstract

Research on ethical leadership in healthcare, despite the sector’s intrinsic ethical foundation, is still limited. This study aims to examine the adoption of ethical leadership among 48 healthcare professionals in managerial roles within the Italian Health Service. Survey results revealed a favorable inclination toward ethical leadership, yet gender disparities in managerial roles highlighted possible ethical imbalances. This underscores the need to champion gender equality and instill uniform ethical values within healthcare organizations, impacting not only management but also leadership development in the healthcare sector.

References

  1. Accordo tra il Ministro della salute, le regioni e le province autonome di Trento e Bolzano sul documento recante: “Linee-guida in tema di raccolta, manipolazione e impiego clinico delle cellule staminali emopoietiche (CSE)” – -- disponibile al sito: https://www.gazzettaufficiale.it/atto/serie_generale/caricaDettaglioAtto/originario?atto.dataPubblicazioneGazzetta=2003-09-30&atto.codiceRedazionale=03A10620&elenco30giorni=false.
  2. Adler P.S. (2002). Corporate scandals: It’s time for reflection in business schools. Academy of Management Perspectives, 16(3): 148-149. DOI: 10.5465/ame.2002.8540425.
  3. Andersson T. (2015). The medical leadership challenge in healthcare is an identity challenge. Leadership in Health Services, 28(2): 83-99. DOI: 10.1108/lhs-04-2014-0032.
  4. Anessi‐Pessina E., Cantù E. (2006). Whither managerialism in the Italian national health service?. The International journal of health planning and management, 21(4): 327-355. DOI: 10.1002/hpm.861.
  5. Avolio B.J., Walumbwa F.O., Weber T.J. (2009). Leadership: Current theories, research, and future directions. Annual review of psychology, 60: 421-449. DOI: 10.1146/annurev.psych.60.110707.163621.
  6. Banks G.C., Fischer T., Gooty J., Stock G. (2021). Ethical leadership: Mapping the terrain for concept cleanup and a future research agenda. The Leadership Quarterly, 32(2): 101471. DOI: 10.1016/j.leaqua.2020.101471.
  7. Banks G.C., Gooty J., Ross R.L., Williams C.E., Harrington N.T. (2018). Construct redundancy in leader behaviors: A review and agenda for the future. The Leadership Quarterly, 29(1): 236-251. DOI: 10.1016/j.leaqua.2017.12.005.
  8. Bismark M., Morris J., Thomas L., Loh E., Phelps G., Dickinson H. (2015). Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia. BMJ open, 5(11), e009384. DOI: 10.1136/bmjopen-2015-009384.
  9. Boniol M., McIsaac M., Xu L. Wuliji T., Diallo K. et al. (2019). Gender equity in the health workforce: analysis of 104 countries. World Health Organization. -- https://apps.who.int/iris/handle/10665/311314.
  10. Brown M.E., Treviño L.K. (2006). Ethical leadership: A review and future directions. The Leadership Quarterly, 17(6): 595. DOI: 10.1016/j.leaqua.2006.10.004.
  11. Brown M.E., Treviño L.K., Harrison D.A. (2005). Ethical leadership: A social learning perspective for construct development and testing. Organisational behavior and human decision processes, 97(2): 117-134. DOI: 10.1016/j.obhdp.2005.03.002.
  12. Brown N., Brittlebank A. (2013). How to develop and assess the leadership skills of psychiatrists. Advances in psychiatric treatment, 19(1): 30-37. DOI: 10.1192/apt.bp.111.009688.
  13. Chervenak F.A., McCullough L.B., Brent R.L. (2013). The professional responsibility model of physician leadership. American Journal of Obstetrics and Gynecology, 208(2): 97-101. DOI: 10.1016/j.ajog.2012.03.005.
  14. Dal Mas F., Paoloni P. (2020). A relational capital perspective on social sustainability; the case of female entrepreneurship in Italy. Measuring Business Excellence, 24(1): 114-130. DOI: 10.1108/MBE-08-2019-0086.
  15. Danish R.Q., Hafeez S., Ali H.F., Mehta A.M., Ahmad M.B., Ali M. (2020). Impact of Ethical Leadership on Organizational Commitment and
  16. Organizational Citizenship Behavior with Mediating role of Intrinsic Motivation. International Review of Management and Marketing, 10(4): 25-30. -- Retrieved from https://econjournals.com/index.php/irmm/article/view/9840.
  17. Deal J. (2018). The ethical downside of having highly loyal leaders. Wall Street J. -- https://www.wsj.com/articles/the-ethical-downside-of-having-highly-loyal-leaders-1527088218 [ultimo accesso 7 aprile 2023].
  18. Deephouse D.L. (1996). Does isomorphism legitimate?. Academy of management journal, 39(4): 1024-1039. DOI: 10.5465/256722.
  19. Dowton S.B. (2004). Leadership in medicine: where are the leaders?. Medical Journal of Australia, 181(11-12): 652-654. DOI: 10.5694/j.1326-5377.2004.tb06509.x.
  20. Fischer T., Dietz J., Antonakis J. (2017). Leadership process models: A review and synthesis. Journal of Management, 43(6): 1726-1753. DOI: 10.1177/0149206316682830.
  21. Fragale E. (2013). La dirigenza delle aziende sanitarie dopo la cd riforma Balduzzi. Le Istituzioni del Federalismo, (2): 551-581.
  22. Freeman J. (2019). Big business and it’s stakeholders. The Wall Street J. -- https://www.wsj.com/articles/big-business-and-its-stakeholders-11566251445 [ultimo accesso 7 aprile 2023].
  23. Giacomelli G. (2020). The role of hybrid professionals in the public sector: a review and research synthesis. Public Management Review, 22(11): 1624-1651. DOI: 10.1080/14719037.2019.1642952.
  24. Glouberman S., Mintzberg H. (2001). Managing the care of health and the cure of disease – Part I: Differentiation. Health care management review, 56-69. -- https://www.jstor.org/stable/44951310.
  25. Heifetz R.A., Laurie D.L. (1997). The work of leadership. Harvard Bus Rev, 75: 124-134. -- https://createvalue.org/wp-content/uploads/Heifetz-The-Work-of-Leadership-1.pdf.
  26. Ho A., Pinney S. (2016, January). Redefining ethical leadership in a 21st-century healthcare system. Healthcare management forum, 29(1): 39-42. DOI: 10.1177/0840470415613910.
  27. Hoch J.E., Bommer W.H., Dulebohn J.H., Wu, D. (2018). Do ethical, authentic, and servant leadership explain variance above and beyond transformational leadership? A meta-analysis. Journal of management, 44(2): 501-529. DOI: 10.1177/0149206316665461.
  28. Hogan R., Curphy G.J., Hogan J. (1994). What we know about leadership: Effectiveness and personality. American psychologist, 49(6): 493. -- https://psycnet.apa.org/doi/10.1037/0003-066X.49.6.493.
  29. Hoque K., Davis S., Humphreys M. (2004). Freedom to do what you are told: senior management team autonomy in an NHS acute trust. Public Administration, 82(2): 355-375. DOI: 10.1111/j.0033-3298.2004.00398.x.
  30. Huikko-Tarvainen S. (2021). Elements of perceived good physician leadership and their relation to leadership theory. Leadership in Health Services. DOI: 10.1108/LHS-01-2021-0002.
  31. Huikko-Tarvainen S., Sajasalo P., Auvinen T. (2021). Just a leader? Leadership work challenges and identity contradiction experienced by Finnish physician leaders. Journal of Health Organization and Management. DOI: 10.1108/JHOM-10-2020-0421.
  32. King’s Fund. (2011). The Future of Leadership and Management in the NHS: No More Heroes: a Report for the King’s Fund Commission on Leadership and Management in the NHS. Kings Fund. -- www.kingsfund.org.uk/publications.
  33. Lander B. (2016). Boundary-spanning in academic healthcare organisations. Research Policy, 45(8): 1524-1533. DOI: 10.1016/j.respol.2016.01.006.
  34. Le donne nel Servizio Sanitario Nazionale, Ministero della Salute, 2022: -- chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.salute.gov.it/imgs/C_17_pubblicazioni_3273_0_alleg.pdf.
  35. Lega F., Prenestini A., Rosso M. (2017). Leadership research in healthcare: a realist review. Health Services Management Research, 30(2): 94-104. DOI: 10.1177/0951484817708915.
  36. Mascia D., Morandi F., Cicchetti A. (2011). Looking good or doing better? Patterns of decoupling in the implementation of clinical directorates. Academy of Management Proceedings, 1: 1-6. DOI: 10.1097/hmr.0b013e318286095c.
  37. Mihelic K.K., Lipicnik B., Tekavcic M. (2010). Ethical leadership. International Journal of Management & Information Systems (IJMIS), 14(5). DOI: 10.19030/ijmis.v14i5.11.
  38. Mintzberg H. (1997). Toward healthier hospitals. Health Care Management Review, 9-18. -- https://www.jstor.org/stable/44950838.
  39. Mitchell T.R. (1982). Motivation: New directions for theory, research, and practice. Academy of management review, 7(1): 80-88. Doi: 10.5465/amr.1982.4285467.
  40. Organisation for Economic Co-Operation and Development (OECD). -- https://stats.oecd.org/.
  41. Porter M.E. (2010). What is value in health care. N Engl J Med, 363(26): 2477-2481. DOI: 10.1056/nejmp1011024.
  42. Prenestini A., Sartirana M., Lega F. (2021). Involving clinicians in management: assessing views of doctors and nurses on hybrid professionalism in clinical directorates. BMC Health Services Research, 21: 1-11. DOI: 10.1093/acprof:oso/9780198289029.001.0001.
  43. Rost J.C. (1995). Leadership: A discussion about ethics. Business ethics quarterly, 129-142. DOI: 10.2307/3857276.
  44. Sartirana M., Currie G., Noordegraaf M. (2019). Interactive identity work of professionals in management: a hospital case study. Public Management Review, 21(8): 1191-1212. DOI: 10.1080/14719037.2018.1549269.
  45. Sirris S. (2019). Coherent identities and roles? Hybrid professional managers’ prioritizing of coexisting institutional logics in differing contexts. Scandinavian Journal of Management, 35(4), 101063. DOI: 10.1016/j.scaman.2019.101063.
  46. Snell A.J., Briscoe D., Dickson G. (2011). From the inside out: the engagement of physicians as leaders in health care settings. Qualitative Health Research, 21(7): 952-967. DOI: 10.1177/1049732311399780.
  47. Spreier S.W., Fontaine M.H., Malloy R.L. (2006). Leadership run amok. Harvard Business Review, 84(6): 72-82. -- https://hbr.org/2006/06/leadership-run-amok-the-destructive-potential-of-overachievers.
  48. Vroom V.H. (1964). Work and motivation. New York: John Wiley & Sons.
  49. Wang E., Hu H., Mao S., Liu H. (2019). Intrinsic motivation and turnover intention among geriatric nurses employed in nursing homes: The roles of job burnout and pay satisfaction. Contemporary nurse, 55(2-3): 195-210. DOI: 10.1080/10376178.2019.1641120.
  50. Witman Y., Smid G.A., Meurs P.L., Willems D.L. (2011). Doctor in the lead: balancing between two worlds. Organization, 18(4): 477-495. DOI: 10.1177/1350508410380762.
  51. Wojciszke B. (1994). Multiple meanings of behavior: Construing actions in terms of competence or morality. Journal of personality and social psychology, 67(2), 222. -- https://psycnet.apa.org/doi/10.1037/0022-3514.67.2.222.
  52. Yidong T., Xinxin L. (2013). How ethical leadership influence employees’ innovative work behavior: A perspective of intrinsic motivation. Journal of business ethics, 116: 441-455. DOI: 10.1007/s10551-012-1455-7.
  53. Yukl G. (2010). Leadership in organisations (7th ed.). Upper Saddle River, NJ: Prentice Hall.
  54. Yukl G., Mahsud R., Hassan S., Prussia G.E. (2013). An improved measure of ethical leadership. Journal of leadership & organizational studies, 20(1): 38-48: DOI: 10.1177/1548051811429352.

Metrics

Metrics Loading ...