Ethical and Professionalism Implications of Physician Employment and Health Care Business Practices: A Policy Paper From the American College of Physicians.

The environment in which physicians practice and patients receive care continues to change. Increasing employment of physicians, changing practice models, new regulatory requirements, and market dynamics all affect medical practice; some changes may also place greater emphasis on the business of medicine. Fundamental ethical principles and professional values about the patient-physician relationship, the primacy of patient welfare over self-interest, and the role of medicine as a moral community and learned profession need to be applied to the changing environment, and physicians must consider the effect the practice environment has on their ethical and professional responsibilities. Recognizing that all health care delivery arrangements come with advantages, disadvantages, and salient questions for ethics and professionalism, this American College of Physicians policy paper examines the ethical implications of issues that are particularly relevant today, including incentives in the shift to value-based care, physician contract clauses that affect care, private equity ownership, clinical priority setting, and physician leadership. Physicians should take the lead in helping to ensure that relationships and practices are structured to explicitly recognize and support the commitments of the physician and the profession of medicine to patients and patient care.

The Effect of Supervisor Identification on Unethical Pro-Supervisor Behavior: The Moderating Role of Employability Perceptions.

Under some employment circumstances, individuals in some organizations are willing to engage in unethical behaviors that benefit one's own supervisors who have a great power to decide the levels of evaluation and compensation for each individual. In this study, two hypotheses were examined. First, based on social identification theory, we hypothesized that individuals' feeling a sense of oneness with one's own supervisors promote unethical pro-supervisor behaviors (UPSB). Second, based on a person-situation interactionist model, we hypothesized that this positive relationship is strengthened if the individual perceives lower levels of one's own employability. Data were collected from 185 individuals of various types of organizations in South Korea. A time-lagged field study supported our hypotheses. In particular, [supervisor identification was positively related to UPSB. Furthermore, for individuals with a weaker employability perception, supervisor identification was positively related to UPSB.

Antibodies as Currency: COVID-19's Golden Passport.

Due to COVID-19, the fragile economy, travel restrictions, and generalized anxieties, the concept of antibodies as a "declaration of immunity" or "passport" is sweeping the world. Numerous scientific and ethical issues confound the concept of an antibody passport; nonetheless, antibodies can be seen as a potential currency to allow movement of people and resuscitation of global economics. Just as financial currency can be forged, so too is the potential for fraudulent antibody passports. This paper explores matters of science, ethics, and identity theft, as well as the problems of bias and discrimination that could promulgate a world of pandemic "golden passports."

Those who tan and those who don't: A natural experiment on colorism.

Are darker-skinned workers discriminated against in the labor market? Studies using survey data have shown that darker skin tone is associated with increased labor market disadvantages. However, it is hard to refute the possibility that other factors correlated with skin tones might affect employment outcomes. To overcome this inherent limitation, we use a natural experiment: we utilize changes in one's own skin tone, generated by exposure to the sun, to explore the effect of skin tone on the tendency to be employed. We find that those people whose skin tone becomes darker by exposure to the sun (but not others) are less likely to be employed when the UV radiation in the previous three weeks in the area in which they reside is greater. These within-person findings hold even when controlling for the week, the year, the region, demographic characteristics and the occupation and industry one is employed in.

What Should Physicians Consider Prior to Unionizing?

Physicians considering unionization face many practical, emotional, and moral obstacles. Even some who feel that a collective bargaining unit is necessary remain concerned that patient care could suffer if physicians unionize. This article discusses unionized physicians' moral obligations to patient populations and health care systems' share in this responsibility. It argues that unionization can be done ethically as long as union actions are focused on improving patient care.

How Should Commerce and Calling Be Balanced?

Physicians and all health professionals need to find an appropriate balance between the interests of individual patients and their organization's bottom line. Corporatization in health care has complicated such efforts. More and more health professionals function as employees of health care organizations, some of which value leaders' and shareholders' interests over those of patients. When faced with such conflicts, physicians bear a responsibility to put patients first and to advocate for their profession.

Bridging the Breach: Using Positive Affectivity to Overcome Knowledge Hiding after Contract Breaches.

With a basis in conservation of resources theory, this study investigates the relationship between employees' exposure to perceived contract breaches and their job performance, while also considering the mediating role of knowledge hiding and the moderating role of positive affectivity. Multisource, three-wave data from employees and their peers in Pakistani organizations reveal that breaches in the psychological contract hinder job performance, because employees respond with an unwillingness to contribute valuable knowledge to execute their job tasks. This mediating role of knowledge hiding is mitigated if employees can draw from their own positive affectivity trait. This study accordingly identifies a key factor, intentional attempts to conceal knowledge requested by other members, that can backfire and make employees suffer doubly: from unfulfilled organizational promises and from lower performance. It also reveals how this risk might be contained, that is, by encouraging employees' positive affect.

A feminist phenomenology on the emotional labor and morality of live-in migrant care workers caring for older people in the community.

BACKGROUND: Global societal changes, such as increasing longevity and a shortage of family caregivers, have given rise to a popular worldwide trend of employing live-in migrant care workers (MCWs) to provide homecare for older people. However, the emotional labor and morality inherent in their interactions with older people are largely unknown. The aim of the present study is to understand the corporeal experiences of live-in migrant care workers in the delivery of emotional labor as seen in their interactions with older people by: (1) describing the ways by which they manage emotional displays with older people; and (2) exploring their morality as enacted through emotional labor. METHODS: We performed a secondary analysis drawing on feminist phenomenology to thematically analyze data from interviews with 11 female MCWs. Follow-up interviews were conducted with 10 participants. The participants had two to 15 years of experience in caring for older people in their homes in Hong Kong. RESULTS: Performing emotional labor by suppressing and inducing emotions is morally demanding for live-in MCWs, who experience socio-culturally oppressive relationships. However, developing genuine emotions in their relationships with older people prompted the MCWs to protect the interests of older people. Through demonstrating both fake and genuine emotions, emotional labor was a tactic that live-in MCWs demonstrated to interact morally with older people. CONCLUSIONS: Emotional labor allowed live-in MCWs to avoid conflict with older people, and to further protect their own welfare and that of others. This study highlights the significance of empowering live-in MCWs by training them in ways that will help them to adapt to working conditions where they will encounter diverse customs and older people who will develop an increasing dependence on them. Thus, there is a need to develop culturally appropriate interventions to empower live-in MCWs to deliver emotional labor in a moral manner.

Ética del trabajo en Ecuador: un análisis de las diferencias en cuatro cohortes generacionales / Work Ethic: analysis of differences between four generational cohorts

Las organizaciones enfrentan el reto de gestionar una fuerza laboral multigeneracional con características propias que difieren en el valor que le otorgan al trabajo. La incorporación al mercado laboral de las generaciones más jóvenes hace imprescindible el estudio de sus diferentes actitudes hacia el trabajo en comparación con las generaciones antecesoras. El propósito de esta investigación fue analizar a través del constructo de la Ética Protestante las diferencias existentes en las actitudes hacia el trabajo de cuatro generaciones (Baby Boomers, Generación X, Generación Y, y Generación Z). La muestra de 624 participantes ecuatorianos (BB 11.2%; GX 11.2%, GY 58.5% y GZ 19.1%) se agrupó por cohortes. Se aplicó el Cuestionario Multidimensional Ética del Trabajo (MWEP). Los resultados mostraron que los BB y la GX tiene una mayor creencia sobre la importancia del trabajo y más tolerancia a la utilización improductiva del tiempo de trabajo que las generaciones Y y Z. En el aplazamiento de las recompensas la GZ muestra puntuaciones superiores a las obtenidas por los BB, GX y GY. No se encuentran diferencias significativas en las dimensiones de autoconfianza, ocio y moralidad-ética

Enterprises face the challenge of managing a multigenerational workforce which has its characteristics that differ in the value they grant to work. Incorporation of younger generations into the labour market requires to study all their attitudes towards work, contrasting them with previous generations. The purpose of this research was to analyse, through the Protestant Ethic construct, the differences of four age groups in attitudes towards work (Baby Boomers, Generation X, Generation Y, and Generation Z). Cohorts grouped the sample of 624 Ecuadorians (BB 11.2%; Gen X 11.2%, Gen Y 58.5% and Gen Z 19.1%). The Multidimensional Work Ethic Profile (MWEP) was applied. The results showed that BB and Gen X believe more in the importance of work than generations Y and Z. At the same time, BB and Gen X are more tolerant to the unproductive use of time than generations Y and Z. Gen Z has higher scores than BB, Gen X and Gen Y in the postponement of rewards dimension. Besides, there are no meaningful differences in self-reliance, leisure and morality/ethics dimensions

The impact of leader moral humility on follower moral self-efficacy and behavior.

This study utilizes social-cognitive theory, humble leadership theory, and the behavioral ethics literature to theoretically develop the concept of leader moral humility and its effects on followers. Specifically, we propose a theoretical model wherein leader moral humility and follower implicit theories about morality interact to predict follower moral efficacy, which in turn increases follower prosocial behavior and decreases follower unethical behavior. We furthermore suggest that these effects are strongest when followers hold an incremental implicit theory of morality (i.e., believing that one's morality is malleable). We test and find support for our theoretical model using two multiwave studies with Eastern (Study 1) and Western (Study 2) samples. Furthermore, we demonstrate that leader moral humility predicts follower moral efficacy and moral behaviors above and beyond the effects of ethical leadership and leader general humility. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Breaking the cycle of abusive supervision: How disidentification and moral identity help the trickle-down change course.

Studies show that abusive leader behaviors "trickle down" to lower organizational levels, but this research ignores that many abused supervisors do not perpetuate abuse by harming their own subordinates. Drawing on social-cognitive theory and related research, we suggest abused supervisors might defy rather than emulate their managers' abusive behavior. Specifically, we predicted that some abused supervisors-namely, those with strong moral identities-might in effect "change course" by engaging in less abuse or demonstrating ethical leadership with their subordinates to the extent they disidentify with their abusive managers. Across 2 experiments (n = 288 and 462 working adults, respectively) and a field study (n = 500 employees and their supervisors), we show that relations between manager abuse and supervisors' abusive and ethical behaviors were carried by supervisors' disidentification, and that the direct and indirect effects of manager abuse were stronger for supervisors with comparatively higher moral identity levels. We discuss our findings' implications and avenues for future research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Employers' views on disability, employability, and labor market inclusion: a phenomenographic study.

Purpose: This study aims to increase our understanding of employers' views on the employability of people with disabilities. Despite employers' significant role in labor market inclusion for people with disabilities, research is scarce on how employers view employability for this group.Methods: This was a qualitative empirical study with a phenomenographic approach using semi-structured interviews with 27 Swedish employers from a variety of settings and with varied experience of working with people with disabilities.Results: The characteristics of employers' views on the employability of people with disabilities can be described as multifaceted. Different understandings of the interplay between underlying individual-, workplace-, and authority-related aspects form three qualitatively different views of employability, namely as constrained by disability, independent of disability, and conditional. These views are also characterized on a meta-level through their association with the cross-cutting themes: trust, contribution, and support.Conclusions: The study presents a framework for understanding employers' different views of employability for people with disabilities as a complex internal relationship between conceived individual-, workplace-, and authority-related aspects. Knowledge of the variation in conceptions of employability for people with disability may facilitate for rehabilitation professionals to tailor their support for building trustful partnerships with employers, which may enhance the inclusion of people with disabilities on the labor market.Implications for rehabilitationEmployers' views on employing people with disabilities vary with respect to individual-, workplace-, and authority-related aspects in relation to trust, contribution and support.Knowledge of the employers' views on the employability of people with disabilities can support professionals in authorities and in vocational rehabilitation.The findings illustrate the importance of analyzing what type of support employers need as a starting point for building trustful partnerships between authority actors and employers.The findings offer a vocabulary that can be used by professionals in authorities and in vocational rehabilitation in tailoring employer-oriented support to increase labor market inclusion of people with disabilities.

How age affects the relation between personality facets and work values of business and private bankers / Cómo afecta la edad a la relación entre las facetas de personalidad y los valores del trabajo de empleados de banca comercial y privada

Personality traits and work values are important characteristics in personnel selection. Studies on their associations show limited agreement. In order to clarify, this paper investigates their association on a personality facet level. Work values are differentiated in intrinsic and extrinsic factors. This paper adds the role of age to the association. Earlier studies on traits and values about the influence of age on their development and associations are reviewed. Then the moderating influence of age in the association between facets of the Five-Factor Model and work values of the Universal Values Model of 465 Dutch bankers is studied. The results elucidate the association between personality facets and work values and the role of age in their associations. Considering this in personnel selection might contribute to sustainable employability of both the young as well as the older worker. Therewith, the study contributes to the debate of ageing in recruitment and selection

Los rasgos de personalidad y los valores laborales son características importantes en la selección de personal. Los estudios sobre sus asociaciones muestran un acuerdo limitado. Para clarificarlo, este artículo investiga su asociación en el nivel de facetas de la personalidad. Los valores laborales se diferencian en factores intrínsecos y extrínsecos. Además este trabajo añade el papel de la edad en esta asociación. Se revisan estudios previos de rasgos y valores sobre la influencia de la edad en su desarrollo y asociación. También se estudia la influencia moderadora de la edad en la asociación entre las facetas del modelo de los cinco factores y los valores laborales del modelo de valores universal en una muestra de 465 empleados de banca holandeses. Los resultados elucidan la asociación entre aspectos de personalidad y valores laborales, y el papel de la edad en dicha asociación. La consideración de esta asociación en selección de personal podría contribuir a la empleabilidad sostenible de los empleados jóvenes y de los de más edad. Por lo tanto, el estudio contribuye al debate de la edad en el reclutamiento y la selección

Should Genetic Testing for Variants Associated with Influenza Infection Be Mandatory for Health Care Employees?

Scientists are beginning to understand more about the role of host genetics in individuals' responses to influenza virus exposure. This fictional case addresses a situation in which a health care organization proposes requiring all health care practitioners with direct patient care responsibilities to undergo mandatory genetic testing for genetic variants used to (1) predict individuals' responses to the influenza vaccine, (2) determine individual susceptibility to influenza infection, and (3) identify individuals at increased risk for severe disease. This commentary will discuss ethical and legal issues associated with use of genetic test results to determine employee work assignments during an influenza pandemic.

The value of work: Addressing the future of work through the lens of solidarity.

Designing the future of work is crucial to the health and well-being of people and societies. Experts predict that developments such as the advancement of digital technologies, automation, and the movement of manufacturing jobs to low-wage countries will lead to major transformations in the labour market, and some foresee significant job losses. Due to the close relationship between employment and health, major job losses would have significant negative impacts on the health and well-being of individuals and societies. Job losses would also pose a major challenge to solidaristic support within societies because they would negatively affect the recognition of similarities among people, which is vital for solidaristic practice and institutions. To prevent these negative effects, a fundamental redesign of the relationship between work and income is necessary. And for this project to succeed, we need to reconsider of the value of work. Building on definitions of flourishing people and societies, we argue that the value of work should not be determined by the labour market, but according to its importance for society. Using a solidarity-based framework we argue that such a re-valuation of work will help to ensure social cohesion and increase reciprocity in our societies. It will serve as a foundation upon which we can reconfigure the relationship between work and income without risking the loss of social cohesion and solidarity.