This developmental paper reports a work in progress study. It aims at investigating microand
macro-level processes related to doctors? professional/religious identity conflict in
critical situations, such as End-of-Life (EoL) circumstances, and the consequences of such
conflict on doctors? psychological well-being (PWB). It achieves this by testing in a
multilevel, moderated mediation analysis four hypotheses in a two-wave study of doctors
working in 30 NHS Trusts in England. By providing a holistic framework on identity conflict
dynamics (its emergence, unfolding and individual consequences), this developmental paper
has the potential to make two key contributions to the literature on identity and identity
conflict as experienced by doctors in EoL circumstance. First, it clarifies micro-level
conditions and mechanisms of professional/religious identity conflict in doctors and its
impact on PWB. Second, by including ?extra-individual? forces as macro-level boundary
conditions, namely organisational ethical climate, it extends identity theories with social
information processing theory.
The purpose of this article is to offer a critical and broad perspective on how transnational companies (TNCs) behave in the global context, focusing its attention on the controversial issue of tax avoidance in the UK. It pursues this aim by taking into account not only economic globalisation, mobility of capital and tax havens, but also ethics and corporate social responsibility.Design/methodology/approach
This article seeks to provide an interdisciplinary viewpoint drawing not only from well-established scholarly literature but also from real cases and evidence, such as the scandals involving corporate giants, such as Starbucks, Google and Amazon in the UK.Findings
This article highlights the fundamental interplay and mutual aid of ethics and international laws, underlining the increasing importance of corporate social responsibility principles in todays? business practices. However, it also emphasises the need of reinforcing these principles with either regional or universalistic legal approaches to tackle TNCs? misconduct in the international arena.Practical implications
This article suggests that by establishing and enforcing international business laws, increasingly aligned with ethical principles, the gap between ethics and legislation can be consistently bridged. Hence, TNCs? behaviour could be more efficiently controlled.Originality/value
The paper contributes to the literature on modern economic globalisation by providing a comprehensive and integrative perspective on TNCs? behaviour, accounting for the interplay of socio-ethical, legal and business principles.
Generalizability in qualitative research has been a controversial topic given that interpretivist scholars have resisted the dominant role and mandate of the positivist tradition within social sciences. Aiming to find universal laws, the positivist paradigm has made generalizability a crucial criterion for evaluating the rigor of quantitative research. This positivist echo has led generalizability to acquire a quantitative meaning, inappropriate for describing qualitative studies. The purpose of qualitative research has thus been directed towards providing in-depth explanations and meanings rather than generalizing findings. Through a critical review of empirical and theoretical studies, this commentary seeks to show that in qualitative domains generalizability is possible provided that: first, generalizability is the main objective of the study; second, due precautions concerning the philosophy and terminology selected are taken. Hence, this commentary contributes to the literature on qualitative research by making suggestions for more consistent and unanimous procedures to adopt in qualitative inquiries.
Legal changes in medical regulations and advancements in medical technology have challenged healthcare organisations? approaches to ethical controversies and influenced healthcare professionals? clinical practice, especially in End-of-Life (EoL) situations. In such situations, healthcare professionals may experience moral identity conflicts and ethical dilemmas. Indeed, the moral code of conduct of doctors and nurses? professional identity can interact with the moral values of their other non-work identities. These ethical conflicts could significantly affect healthcare professionals? actions, patient care and quality of healthcare. Although a thorough understanding of identity conflict emergence, perception and influence would help healthcare professionals and organisations to promptly respond to such consequences, research has not exhaustively addressed these ethical conflict dynamics.
Therefore, through an interdisciplinary perspective integrating theoretical and empirical works in management/organisation studies and medical literature, this paper explores healthcare professionals? ethical identity conflicts perception and behaviour in EoL circumstances. To pursue this aim, a qualitative research methodology has been chosen. Semi-structured interviews (N=54) are conducted among healthcare professionals, implementing both theoretical sampling, to strengthen the rigour of the study, and random sampling, to ameliorate any potential selection bias. The tradition of thematic analysis is followed to analyse the data. Hence, by offering an in-depth understanding of how ethical conflicts are experienced by doctors and nurses and bringing new insights on healthcare professionals? behavioural consequences in terms of decision making and clinical practice, this paper enriches current works on ethical identity conflicts proposing findings and themes related to spiritual/religious identity, moral identity, procrastination of duties and absenteeism.
Due to the increasing diversity and complexity of today?s society, identity conflicts represent an unpredictable challenge in workplace environments (Horton et al., 2014). Legal changes in medical regulations and advancements in medical technology have accentuated uncertainty in healthcare organisations (Karnik & Kanekar, 2016), exposing healthcare professionals to identity conflicts in the form of personal struggles and ethical dilemmas (Hurst et al., 2005). Indeed, doctors and nurses? decision-making responsibility and clinical practice influence other people?s lives, especially in End-of-Life (EoL) circumstances (Kälvemark et al., 2004).
In these ethically-charged circumstances doctors and nurses? professional identity values can interact with their other non-work identities values (Curlin et al., 2007), leading to identity conflict experience (Ashforth et al. 2008). Such identity conflicts can impact healthcare professionals? psychological outcomes (Genuis & Lipp, 2013), decision making (Hurst et al., 2005), patient care (Bedford, 2012) and quality of the healthcare system (Sulmasy, 2008). Despite these serious consequences at individual, organisational and societal levels, how such ethical identity conflicts in healthcare professionals arise, are perceived and affect their behaviour remains unclear.
Due to the increasing diversity and complexity of today?s workplaces, individuals may experience identity conflict between the multiple identities they hold. Working under pressure and high uncertainty, healthcare professionals may face identity conflict between their professional and personal identities and values, especially in challenging situations. Although such conflict can significantly affect doctors and nurses? psychological and behavioural responses and, ultimately, the quality of the healthcare system, how identity conflict emerges and unfolds remains unclear. By integrating works in organisational- management and medical literature, we thus explore healthcare professionals? identity conflict dynamics in challenging situations, such as End-of-Life circumstances. We conducted a qualitative study, using semi-structured interviews (N= 47), among healthcare professionals working for the English National Healthcare Service. We implemented both theoretical and random samplings and followed grounded theory approaches to analyse the data. Our findings show that identity conflict was perceived between different identities but also within the same identity and, surprisingly, the conflict was stimulated by perspective taking processes. Lastly, behavioural responses to identity conflict included seeking peer support and doing reflective practices, whereas its psychological consequences unexpectedly embrace identity growth and positive learning dynamics. Hence, this paper contributes to and extends newer approaches in the identity literature by, firstly, focusing on identity conflict in depth, as one of the intrapsychic relationships of multiple identities simultaneously activated; and, secondly, unravelling some of the conditions whereby identity conflict can emerge and affect healthcare professionals? psychological and behavioural responses.
In ethically-charged situations, such as End-of-Life circumstances, healthcare professionals may face identity conflict of moral nature due to incongruent values belonging to their multiple identities, e.g. professional and religious identities. Such conflict can significantly influence healthcare professionals' psychological outcomes, their practice and the overall quality of the healthcare service. However, despite these critical consequences, how identity conflict emerges, unfolds and affects doctors and nurses remains mostly unexplored. The overarching aim of this thesis is to advance the understanding of individual and socio-ethical dynamics of identity conflict. This aim is addressed through a mixed-method approach developed in three papers: a propositional paper, in which a narrative review is conducted; a qualitative paper, in which an inductive investigation based on semi-structured interviews is carried out; a quantitative paper, in which a mediated-moderation, multilevel analysis is run, implementing a two-time-lagged, questionnaire-based, design. This thesis extends the literature on identity conflict in four ways: (1) by conceptually integrating and explaining multiple individual and socio-ethical dynamics associated with identity conflict in a comprehensive and theoretically-justified model; (2) by providing an in-depth understanding of individual-level identity conflict dynamics, through the incorporation of novel ethical virtue-based decision-making approaches able to account for professional and religious values, emotions and interpersonal processes; (3) by exploring healthcare professionals' psychological and behavioural responses to identity conflict; (4) by sheding light on the extent to which individual and socio-ethical forces can affect identity conflict dynamics, thus filling a methodological gap in the identity literature regarding the implementation of multilevel approaches in identity research.
Over the last two decades behavioural economics has gained much momentum among scholars because of its innovative and controversial ways of explaining processes and mechanisms underpinning individuals? judgements and decision making. Thanks to these features, behavioural economics has been applied to diversified domains, namely finance, public choice and marketing. Although the intrinsic characteristics of the health care sector, ranging from incomplete and asymmetrical information to high frequency of critical choices, make the sector a fertile ground for behavioural economics applications, research on the influences of behavioural economics on health care and clinical decision making are still rather fragmented. Therefore, through an interdisciplinary literature review integrating behavioural economics research with medical and behavioural decision-making studies, this article contributes to behavioural decision-making literature by providing a wide overview of how behavioural economics strategies may impact, and be implemented in, diverse health care circumstances. Examples of behavioural economics applications to health care circumstances include: organ donation and transplantation; habitual choices; individuals? loss aversion and trust; present-biased preference; decision fatigue and excessive choice. Hence, this article aims to promote the effective behaviour of both consumers and providers in health care.