The impact of hospital organization in the ethical act of hospital management
Bibliographic record
Abstract
Objective: There are different levels of decision and clinical, administrative and management procedures in a hospital organization. The exercise of management and bioethics should be seen as an interconnected operation by anyone committed to an ethical conduct. This article is based on a larger study under a PhD in Bioethics and was conducted in 25 Portuguese hospitals. The objective of the article is to determine whether hospital organization is predictive of the ethical act of its managers.Methods: We have developed a correlational study using the Questionnaire of Ethicity in Hospital Management (QEHM). It was conducted with a sample of 421 professionals with management positions in Care Units/Services, Management Departments/Units, Boards of Directors of the National Health Service and hospitals connected to the Ministry of Health. The sample is also composed of different management models, representative of the Public, Private and Social sectors.Results: A significant association/correlation was discovered in the following dimensions: Accountability and quality, Ethical weighing and Costs and ethics within the management models; Ethical weighing and Ethical decision within the management level; Costs and ethics and Economical and ethical restriction within age.Conclusions: The ethical act of hospital managers, besides being associated with the hospital management model, is not independent of the managers’ age, being influenced by the organizational structure, particularly at management level. This means that hospital organization has an impact in the ethical act of hospital management. Given the correlational nature of the study and the current health sector reforms in Portugal, we suggest an observational study to examine the implications of the organization in the ethical act of managers and their impact on health care users, which was not included in this study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.073 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".