Identity and moral responsibility of healthcare organizations

In this paper the moral responsibility of a Healthcare Organization (HCO) is conceived as an inextricable aspect of the identity of the HCO. We attempt to show that by exploring this relation a more profound insight in moral responsibility can be gained. Referring to Charles Taylor we explore the meaning of the concept of identity. It consists of three interdependent dimensions: a moral, a dialogical, and a narrative one. In section two we develop some additional arguments to apply his concept of personal identity to organizations. The final section works out the relationship of three dimensions of identity to some actual issues in contemporary HCOs: the tension between care and justice, the importance of dialogues about the diversity of goods, and the relevance of becoming familiar with the life-story of the HCO. Identity of an HCO is established and developed in commitments to and identification with certain goods that are central for a HCO. However, many of these goods are interwoven with everyday practices and policies. Therefore, moral responsibility asks for articulation of goods that often stay implicit and should not be reduced to a merely procedural approach. However difficult this articulation may be, if it is not tried at all HCOs run the risk of drifting away from their very identity as healthcare institutions: to offer care to patients and to do this in accordance with demands of social justice.     

Welfare,Justice, and Pareto Efficiency

In economic analysis, it is usually assumed that each individuals well-being (mental welfare) depends on her or his own resources (material welfare). A typology is provided of the ways in which one persons well-being may depend on the material resources of other persons. When such dependencies are taken into account, standard Paretian analysis of welfare needs to be modified. Pareto efficiency on the level of material resources need not coincide with Pareto efficiency on the level of well-being. A change in economic conditions that is Pareto efficient in the standard sense, i.e., with respect to material resources, may nevertheless sacrifice one persons well-being to that of another. It is shown that under plausible assumptions, Pareto efficiency on the level of well-being may require the reduction of inequality on the level of material resources.     

Inequalities in Health and Intergenerational Equity

In the popular folklore three-score-years-and-ten is treated as a fair innings for people, and thereby serves as an informal reference point for judgements about distributive justice within a community. But length of life alone is an insufficient basis for such judgements - a person's health-related quality-of-life also needs to be taken into account. If one of the objectives of public policy is to reduce inequalities in lifetime health, it will be demonstrated that this is very likely to require systematic discrimination against the older members of a community. The notion of community solidatity will also be tested, because a decision will need to be made as to whether the same fair innings applies to all members of the community, or whether some are entitled to more than others. The strength of the fair innings principle is that it brings these issues to the fore in a systematic way which should ais their resolition in a practical context.     

Justice and Game Advantage in Sporting Games

This paper is a case study of what Jon Elster calls "local justice"; particular schemes of justice which, on a relatively autonomous basis, are designed and implemented by institutions and practices to meet particular preferences and goals. The paper suggests an interpretation of the role of justice in sporting games. First, a framework for examinations of schemes of local justice is suggested. Second, norms are suggested that express the requirements that have to be met in order to consider a sporting game as just. The discussion shows that sports are characterized by a particular blend of meritocratic justice in which goods and burdens are distributed according to performance, and a non-meritocratic distribution through which goods and burdens arise as matters of chance. The essay concludes by arguing that the optimal blend of meritocratic justice and chance results in the realization of not merely fair sporting games, but of exciting and good games as well.     

Integrating Hip‐Hop Culture and Rap Music Into Social Justice Counseling With Black Males

In this article, the author suggests that Hip‐Hop culture and rap music, in particular, can be integrated into individual counseling interactions with Black male clients to discuss the social injustices (e.g., hypercriminalization) they face. Literature examining the history of Hip‐Hop culture and how rap music has been used therapeutically with Black males is presented. The article concludes with a vignette illustrating how Elligan's ( 2000 ) rap therapy framework can help explore experiences Black male clients encounter.     

Feminist identity and program characteristics in the development of trainees’ social advocacy

Feminism, multiculturalism, and social justice (SJ) are closely related constructs, with an important shared emphasis on societal barriers and client empowerment. Yet, research on the relationships between the three variables in their links to counselor advocacy remains scarce. Employing the Input–Environment–Outcome framework, this study examined the unique contributions of 235 female trainees’ feminist identity, training environment SJ supports, and training multicultural focus in explaining trainees’ advocacy using a three-step hierarchical MMLR model. Findings revealed that all three factors were important to trainees’ advocacy. However, the extent to which each factor influenced advocacy varied. For instance, the more strongly identified trainees were with the Feminist Identity Active Commitment stage, the more likely they were to engage at all four levels of advocacy. Conversely, the more aligned trainees were with Passive Acceptance, the less likely they were to empower clients. Moreover, although both training environment SJ support and multicultural focus were influential, SJ training environment was a better predictor of trainee’s advocacy than multicultural training environment. These findings not only highlight the distinctions between SJ and multiculturalism, but also argue for the importance of SJ training in addition to multicultural training. Implications for theories, training, and practice are discussed.     

Retribution and Restoration as General Orientations Towards Justice

We proposed two distinct understandings of what justice means to victims and what its restoration entails that are reflected in individual‐level justice orientations. Individuals with a retributive orientation conceptualize justice as the unilateral imposition of just deserts against the offender. In contrast, individuals with a restorative orientation conceptualize justice as achieving a renewed consensus about the shared values violated by the offence. Three studies showed differential relations between these two justice orientations and various individual‐level values/ideologies and predicted unique variance in preferences for concrete justice‐restoring interventions, judicial processes and abstract justice restoration goals. The pattern of results lends validity to the understanding of justice as two distinct conceptualizations, a distinction that provides much needed explanation for divergent preferences for injustice responses. Copyright © 2011 John Wiley & Sons, Ltd.     

How to Promote Innovative Behavior at Work? The Role of Justice and Support Within Organizations

To provide a more developed research model of innovation in organizations, we reconsidered current thinking about the effects of organizational justice on innovative behavior at work. We investigated the mediating role of perceived organizational support (POS) between the two constructs. As hypothesized, empirical results showed that justice dimensions were related to innovative behavior of employees, whereas all of their relationships became no longer significant when POS intervened (full mediation). This indicates that organizational justice promotes innovative behavior through the psychological mechanism of POS rather than directly. We discussed implications and limitations of this study, and proposed future research avenues.     

Taiwanese Employees' Justice Perceptions of Co-Workers' Punitive Events

Abstract

The authors examined justice perceptions of Taiwanese employees in response to co-workers' punitive events (punishment by a superior). They developed a hypothesis based on Chinese indigenous wu-lun principles and the concept of empathy. Results of the study showed that perceived vertical (between superior and subordinate) and horizontal (between subordinates) relationships jointly affected justice perceptions. Respondents who perceived low (negative) leader-member exchange with the superior and high (positive) liking of the punished person showed the lowest justice perceptions. In conclusion, the authors note that comparative analysis of organizational justice is a promising direction for future research.     

Justice and Organizational Citizenship Behavior Intentions: Fair Rewards Versus Fair Treatment

Abstract

In a sample of 114 employees from various industries, organizations, and positions, the likelihood of organizational citizenship behaviors (OCB) increased when employee perceptions of fair treatment by supervisors became more positive. Perceptions of fair rewards and fair formal procedures were not predictors of OCB intentions. After the authors controlled for established patterns of OCB and demographic characteristics, interactional justice perceptions were significantly related to the intention of performing specific organizationally beneficial activities.