Management Challenges of Private Healthcare Managers in Ethical Decision Making

Management Challenges of Private Healthcare Managers in Ethical Decision Making
3.1 Introduction
Due to the increasing number of scandals in the corporate scene, the interests of scholars and practitioners in business ethics has grown (O’Fallon and Butterfield 375). Initially, the mainstream journals used to publish just a few articles on the story; however, recently, the topic has managed to become a standalone topic and journals dedicated specifically to the topic like the Business Ethics Quarterly and the Journal of Business Ethics have emerged. Despite the fact that journals devoted to the topic have only recently emerged, the area of ethical decision making is not a new field of study in business. Many scholars, by the 1960s and 70s, had already written scholarly articles on the topic (Detert, Treviño, and Sweitzer 374). Some of these researchers were Raymond Baumhart who talked about teaching and researching on business ethics, and Bohr and Kaplan who looked into the reasons behind the protests of healthcare workers (Detert, Treviño, and Sweitzer 374). The latter concluded that the main reason behind the protests was a complex issue with ethical decision making. After the publications by these three scholars, more and more studies have been done and published in the same area. Some of the studies just gave an extensive description ethical decision making while others emphasized on how to implement things like moral codes within the settings of various organizations. This section of the research gives a description of some of the methods that were used to highlight and prove the nature of the some of the challenges that private healthcare managers face in ethical decision making.

3.2 Overview of the Factors Affecting Ethical Decision Making
To comprehensively look into the literature on the challenges that private managers in the healthcare setting face in ethical decision making, the research reviewed more than ten articles published within the last two decades on the topic of ethical decision making and the challenges that come with it. The literature review on the subject revealed that almost more than a hundred articles had been published on the issue of ethical decision making over the last two decades (Bagdasarov et al. 3). Most of the reviewed articles used the responses that people gave on ethical dilemmas and scenarios that the researchers are carefully crafted. The use of questionnaires was the second most common method that the reviewed articles used to acquire information about ethical decision making in business (Lehnert, Yung-hwal, and Nitish 197). Just a few of the papers responded to the challenges that they face at their workplace while trying to make ethical decisions or to a self-analysis of their personal ethical behavior at their places of work. For this study, the review of the literature was focused on four factors and how they pose a challenge to the ethical decision making of managers in the private healthcare sector. These factors were the ethical factors, individual factors, organizational factors, and external factors.
3.3 Classifying the factors that Influence Ethical Decision Making
To produce a clear taxonomy based on factual evidence, it was significant to classify all the factors that influence ethical decision making into groups based on the how the nature of their impact. For this research, the categories that were settled on were: individual factors, ethical factors, external factors, and organizational factors (Matin 22). These four classifications include all the possible elements or factors that could influence the ethical decision-making process of any managers, including a manager in a private health institution. The individual factors cover aspects of age, education, and gender; the external factors include the political, competitive, and social elements; the organizational factors talk about the training and ethical codes and finally; the ethical factors speak of the moral dimensions that influence decision making (Rubens and Edwards 17). These four classifications did not just provide an exhaustive summary of all the factors that affect ethical decision making; they also represented the groups that have been employed in many ethical decision-making models (Pitesa and Stefan 638). These four teams also do represent the macro, micro, and meso levels of decision making that are commonly discussed in most scholarly spheres (Schrempf-Stirling, Guido, and Robert 28). Therefore, the grouping was a very necessary step in exploring the challenges that private healthcare managers face while making ethical decisions (Detert, Treviño, and Sweitzer 374).
3.4 The Degree of Influence of Each Factor on Ethical Decision Making
It is worth noting that the focus of research on ethical factors has increased drastically in the last decade. This significant increase in studies on ethical factors is the primary reason why ethical factors were included in the proposed research taxonomy as a separate category and not as an individual factor. The array of ethical factors being investigated has also increased in the past five years as reported by (Yu 581). From the reviewed literature, deontology and idealism were found to have a positive influence on ethical decision making. The pieces of literature also revealed that there is a negative relationship between ethical decision making and economic factors. Personal behavior was also another ethical element that was prominent amongst the issues that affect ethical decision making (Valentine et al. 515). This study did a general review of many ethical factors that influence decision making and narrowed down to the ones mentioned above as the main ethical factors affecting decision making.
Personal factors are those factors that are directly linked to the individual making the decision. These factors could include factors like age, education, gender, moral development, and professional experience etcetera. Just like the ethical factors, various individual elements have different degrees of influence on the ethical decision-making process of a person (O’Fallon and Butterfield 410). Organizational factors, on the other hand, are those issues that are inherent to a particular organization and can, in some way, influence the way the managers in that institution make ethical decisions. All if these factors, including the external factors that are neither owned by the organization nor the individual but influence the person’s decision-making process, were reviewed. The literature review revealed that each group had specific elements that appeared to have the most impact on the ethical decision making. The study then narrowed down on these few aspects and researched on how they pose a challenge to the ethical decision-making process of managers in the private healthcare sector.
3.5 Conclusion
The review of the literature has provided a taxonomy, based on evidence from the last twenty years, into the factors that influence ethical decision making in various sectors of the economy. From the review, there were at least twenty-six factors that were found to be affecting the ethical decision-making process of individuals. These factors were then grouped into four categories; individual, ethical, external, and organizational. Each of these factors that influence the process of decision making of regular employees also affects the ethical decision-making processes of managers in every sector, including the private health sector. The grouping of these factors in the manner adopted by the research set the stage for further multidimensional studies on the things that influence the decisions that managers make at work. The further study that was enabled by the grouping of the factors then helped reveal how these factors pose challenges to managers while making ethical decisions, and how they specifically affect people in the managers in the private healthcare industry.
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