Article Text
Abstract
Public benefit corporations are National Health Service, that is, state, entities whose function to provide healthcare in discharge of public duties. If we regard value as the output of such organisations, it seems logical to connect the values of the organisation to the value produced by such organisations. But, on closer examination there are competing underlying logics in play: (1) those based on promoting organisational efficiency and efficacy; and (2) those based on the idea of building service provision around the clinician–patient relationship. Underlying these logics are differing value sets. These clash. Because of the clashing of underlying moral frameworks the connection between values and value becomes hard, if not impossible. This paper argues that (1) the clash in these moral frameworks must be addressed by the organisation rather than between individuals or groups of individuals within the organisation; (2) alloying duties within hybrid professionals submerges but does not resolve these conflicts; (3) one approach could be to impose on the organisation itself an ethical imperative to promote, enhance and protect from deterioration the welfare of the patients; (4) a board ethics committee is a possible organisational structure that could transparently and fairly balance clashes within the competing moral frameworks in a way that could reconcile the competing logics and (5) if such conflicts can be better resolved at the organisational level what the organisation must do to achieve its objectives will become clearer because what needs to be valued would naturally emerge connecting values, value and what is valued.
- clinical ethics
- ethics
- legal aspects
- regulation
Statistics from Altmetric.com
Footnotes
Twitter @rajmohindra1
Contributors RM is the sole author.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The views in this article are personal views only.
Competing interests RM is a consultant cardiologist, chair of a clinical ethics Committee, Current chair of the UK Clnincal Ethics Network and a member of the Royal College of Physicians Committee on Ethics in Medicine.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement There are no data in this work
Request Permissions
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Copyright information:
Read the full text or download the PDF:
Other content recommended for you
- Culture, compassion and clinical neglect: probity in the NHS after Mid Staffordshire
- A qualitative study of diverse providers ' behaviour in response to commissioners, patients and innovators in England: research protocol
- Financial modelling of femtosecond laser - assisted cataract surgery within the National Health Service using a ‘ hub and spoke ’ model for the delivery of high - volume cataract surgery
- Spoken communication and patient safety: a new direction for healthcare communication policy, research, education and practice
- Commissioning through competition and cooperation in the English NHS under the Health and Social Care Act 2012: evidence from a qualitative study of four clinical commissioning groups
- Brief behavioural intervention, delivered as standard care, to support physical activity engagement in men with prostate cancer: a pilot study protocol
- Human trafficking and health: a cross-sectional survey of NHS professionals ’ contact with victims of human trafficking
- From research to practice: results of 7300 mortality retrospective case record reviews in four acute hospitals in the North - East of England
- Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency
- Understanding tensions and identifying clinician agreement on improvements to early - stage chronic kidney disease monitoring in primary care: a qualitative study