Treating an unhealthy organisational culture : the implications of the Bundaberg Hospital inquiry for managerial ethical decision making

This paper explores the interplay between individual values, espoused organisational values and the values of the organisational culture in practice in light of a recent Royal Commission in Queensland, Australia, which highlighted systematic failures in patient care. The lack of congruence among values at these levels impacts upon the ethical decision making of health managers. The presence of institutional ethics regimes such as the Public Sector Ethics Act 1994 (Qld) and agency codes of conduct are not sufficient to counteract the negative influence of informal codes of practice that undermine espoused organisational values and community standards. The ethical decision-making capacity of health care managers remains at the front line in the battle against unethical and unprofessional practice. What is known about the topic? Value congruence theory focusses on the conflicts between individual and organisational values. Congruence between individual values, espoused values and values expressed in everyday practice can only be achieved by ensuring that such shared values are an ever-present factor in managerial decision making. What does this paper add? The importance of value congruence in building and sustaining a healthy organisational culture is confirmed by the evidence presented in the Bundaberg Hospital Inquiry. The presence of strong individual values among staff and strong espoused values in line with community expectations and backed up by legislation and ethics regimes were not, in themselves, sufficient to ensure a healthy organisational culture and prevent unethical, and possibly illegal, behaviour. What are the implications for practitioners? Managers must incorporate ethics in decision making to establish and maintain the nexus between individual and organisational values that is a vital component of a healthy organisational culture.

"Klo-Ku-Ba", Hans and Elizabeth Krakauer's first apartment in the basement of the Jewish Hospital; Hannover, Germany.

"Klo-Ku-Ba" the first apartment of Hans and Elizabeth in the basement of the Jewish Hospital in Hannover, Germany. The one room served as kitchen, bedroom, and bathroom which was shared by the other residents on the medical staff. Klo-Ku-Ba: Klosett, Kueche, Bad

"Klo-KU-BA", Hans and Elizabeth Krakauer's first marital apartment in the basement of the Jewish Hospital; Hannover, Germany Architecture; Residences; Interior

Digital Image

"Klo-Ku-Ba", Hans and Elizabeth Krakauer's first apartment in the basement of the Jewish Hospital; Hannover, Germany.

"Klo-Ku-Ba" the first apartment of Hans and Elizabeth in the basement of the Jewish Hospital in Hannover, Germany. The one room served as kitchen, bedroom, and bathroom which was shared by the other residents on the medical staff. Klo-Ku-Ba: Klosett, Kueche, Bad

"Klo-KU-BA", Hans and Elizabeth Krakauer's first marital apartment in the basement of the Jewish Hospital; Hannover, Germany Architecture; Residences; Interior

Digital Image

25th Anniversary of the Linked Life Insurance Commemorative Medal

Obverse: Inscription. Reverse: The life insurance emblem, a house with family inside, shekel coin on the roof of the house.

Letter to S.D. Woodruff signed by Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company

Letter (1 page, typed) to S.D. Woodruff asking for the papers for the Crick loan. This is signed by Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company. The letter is torn, has holes in it and is somewhat crumpled and stained. This does not affect the text, June 7, 1887.

Letter to S.D. Woodruff from Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company

Letter (1 page, typed) to S.D. Woodruff from Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company requesting the papers for the Crew and Atkins loans. The letter is discoloured along the folds. This does not affect the text, Nov. 20, 1887.

Letter to S.D. Woodruff from Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company

Letter (1 page, typed) to S.D. Woodruff from Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company requesting the Dennis loan papers, Jan. 6, 1888.

Letter to S.D. Woodruff from Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company

Letter to S.D. Woodruff from Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company to please look for the Maria Cogswell loan papers, Aug. 14, 1888.

Letter to S.D. Woodruff from Wm. Shelley, treasurer of the Jarvis-Conklin Mortgage Trust Company

Letter to S.D. Woodruff which accompanied to check for the Maria Cogswell account. The letter was sent by Wm. Shelley, treasurer of Jarvis-Conklin Mortgage Trust Company, May 25, 1889.

A critical account of the relationship between institutional trust, risk perception, and technology acceptance with an application to genetically modified foods

This article critically reflects on the widely held view of a causal chain with trust in public authorities impacting technology acceptance via perceived risk. It first puts forward conceptual reason against this view, as the presence of risk is a precondition for trust playing a role in decision making. Second, results from consumer surveys in Italy and Germany are presented that support the associationist model as counter hypothesis. In that view, trust and risk judgments are driven by and thus simply indicators of higher order attitudes toward a certain technology which determine acceptance instead. The implications of these findings are discussed.