The Effects of Ethical Climate on Moral Distress

One question that has to be considered is how much the ethical climate or the organizational culture of a hospital plays a role in determining moral distress and the propensity for moral disengagement among U.S. medical residents. There are various definitions or interpretations of what organizational culture is. For instance, organizational culture has been described as the shared values members of a cooperative group have reflected on, articulated, and accepted as normative [1]. Malloy et al. define it as the “nature of the perception of values, beliefs, and behavior of its members” [2]. When referring to ethical climate as an integral component of organizational culture specifically, Malloy et al. regard it as “the collective perception of what is ethically acceptable within the context of an organization” [2]. Thus, an ethical climate encapsulates an informal yet collective and unanimous perception of what individuals deem acceptable and unacceptable behavior. For Spencer et al., organizational ethical climates incorporate the “shared perceptions of the general and pervasive characteristics of an organization affecting a broad range of decisions” [3]. A positive ethical climate amalgamates an organization’s vision with its goals, especially if its values reflect acceptable societal norms consistent with ethical practice. Within the context of health care, Rodney et al. have articulated a moral climate to mean the “implicit and explicit values that drive health care delivery and shape the workplaces in which care is delivered” [4]. McDaniel described an ethical environment as one in which ethical values guide behavior, including setting priorities that provide for the ethical treatment of patients [5].